Objective  To systematically evaluate the risk factors for adverse pregnancy outcomes (APO) in pregnant women with gestational diabetes mellitus (GDM).

Methods CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, Embase, and The Cochrane library were searched for literature on risk factors for APO in pregnant women with GDM from the establishment of the databases to March 22, 2024. Meta-analysis was performed using the RevMan 5.4 and Stata 16.0 softwares.

Results  20 articles were included and 14 risk factors were integrated. The results of Meta-analysis showed that age ≥35 years [OR=3.02, 95%CI(2.02-4.52), P<0.001], pre-pregnancy body mass index (BMI) ≥24.0 kg·m^-2[OR=2.31, 95%CI(1.51-3.54), P<0.001], and weight gain ≥16 kg during pregnancy [OR=4.50, 95%CI(2.24-9.06), P<0.001], adverse maternal history [OR=2.05, 95%CI(1.76-2.38), P<0.001], family history of diabetes mellitus [OR=1.97, 95%CI(1.68-2.30), P<0.001], fasting blood glucose [OR=1.45, 95%CI(1.17-1.81), P<0.001], glycosylated hemoglobin [OR=1.22, 95%CI(1.08-1.37), P=0.001], 3 abnormal blood glucose indexes in oral glucose tolerance test (OGTT) [OR=2.60, 95%CI(1.72-3.93), P<0.001], poor glycemic control during pregnancy [OR=3.23, 95%CI(1.85-5.64), P<0.001], low serum glucagon-like peptide-1 (GLP-1) level [OR=2.30, 95%CI(1.62-3.27), P<0.001], comorbid gestational hypertension [OR=1.77, 95%CI(1.03-3.05), P=0.040], and total cholesterol [OR=1.26, 95%CI(1.15-1.38), P<0.001] were risk factors for APO in pregnant women with GDM.

Conclusion  Age ≥35 years, pre-pregnancy BMI ≥24.0 kg·m^-2, weight gain during pregnancy ≥16 kg, adverse maternal history, family history of diabetes, fasting glucose, glycated hemoglobin, 3 abnormal blood glucose indexes in OGTT, poor glycemic control during pregnancy, low serum GLP-1 level, combined gestational hypertension, and total cholesterol were the risk factors for APO in pregnant women with GDM, which provided a theoretical basis for the prevention, diagnosis and treatment, and care of APO in this population.

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