Clinical and Behavioural Heterogeneity Among Women at Increased Risk for Gestational Diabetes: A Four-Country Analysis

Sharleen L. O’Reilly (), Ellen Greene, Fionnuala M. McAuliffe, Helena Teede, Cristina Campoy, Christy Burden, Aisling Geraghty, Mercedes G. Bermúdez, Anna Davies, Cheryce L. Harrison, Helle Terkildsen Maindal, Vincent L. Versace, Ditte Hjorth Laursen, Timothy Skinner and on behalf of the IMPACT DIABETES B2B Collaboration Group
Additional contact information
Sharleen L. O’Reilly: School of Agriculture and Food Science, University College Dublin, D04 V1W8 Dublin, Ireland
Ellen Greene: School of Agriculture and Food Science, University College Dublin, D04 V1W8 Dublin, Ireland
Fionnuala M. McAuliffe: UCD Perinatal Research Centre, School of Medicine, University College Dublin and National Maternity Hospital, D02 YH21 Dublin, Ireland
Helena Teede: Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne 3800, Australia
Cristina Campoy: Department of Pediatrics, School of Medicine, University of Granada, 18012 Granada, Spain
Christy Burden: Academic Women’s Health Unit, Bristol Medical School, University of Bristol, Bristol BS8 1QU, UK
Aisling Geraghty: School of Agriculture and Food Science, University College Dublin, D04 V1W8 Dublin, Ireland
Mercedes G. Bermúdez: Department of Pediatrics, School of Medicine, University of Granada, 18012 Granada, Spain
Anna Davies: Academic Women’s Health Unit, Bristol Medical School, University of Bristol, Bristol BS8 1QU, UK
Cheryce L. Harrison: Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne 3800, Australia
Helle Terkildsen Maindal: Department of Public Health, Aarhus University, 8000 Aarhus, Denmark
Vincent L. Versace: Deakin Rural Health, Faculty of Health, Deakin University, Geelong 3220, Australia
Ditte Hjorth Laursen: Liva Healthcare, 1434 Copenhagen, Denmark
Timothy Skinner: School of Psychology, Faculty of Health, Deakin University, Geelong 3200, Australia
on behalf of the IMPACT DIABETES B2B Collaboration Group: Membership of the IMPACT DIABETES B2B Collaboration Group is provided in the Acknowledgments.

IJERPH, 2025, vol. 22, issue 7, 1-16

Abstract: Gestational diabetes mellitus (GDM) is a growing global health concern due to its impact on maternal and infant health. GDM risk factors vary across populations, but international comparisons using standardised assessment tools are lacking. This study aimed to examine variations in risk factors, demographics and health behaviours among pregnant women at increased risk of GDM across four international sites and to investigate factors associated with maternal body mass index (BMI), a modifiable risk factor for GDM. This cross-sectional study included data from 804 pregnant women in Dublin ( n = 213), Bristol ( n = 205), Granada ( n = 211) and Melbourne ( n = 175) identified as having an increased risk of GDM, using the Monash GDM screening tool. Between-site differences were analysed using analysis of variance, Kruskal–Wallis and chi-square tests and factors associated with BMI at each site were examined using multiple linear regression. Despite standardised risk screening, significant heterogeneity was observed between sites in key GDM risk factors, including age (mean range 33.8–36.7 years), BMI (Melbourne 28.9 vs. Granada 26.9 kg/m 2 ), physical activity (34.86–41.77 METs/week) and dietary intake (mean energy 1881–2136 kcal/day). Multiple factors were independently associated with BMI, including education level, ethnicity, health literacy and energy intake, with patterns varying by site. This study challenges the concept of a homogeneous “high-risk” GDM population by revealing substantial variations in risk factors and characteristics across different patient cohorts, highlighting the importance of developing context-sensitive approaches to GDM prevention.

Keywords: gestational diabetes mellitus; pregnancy; obesity; prevention; risk factors; health literacy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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