Impact of Continuity of Care on Neonatal Outcomes in Gestational Diabetes Mellitus: A Retrospective Controlled Study
School of Nursing and Health Management, Wuhan Donghu College, Wuhan, Hubei, China
Abstract
Background: Gestational diabetes mellitus (GDM) increases the risk of adverse neonatal outcomes, including preterm birth, macrosomia, neonatal hypoglycemia, and admission to the neonatal intensive care unit (NICU). While continuity of care has been shown to improve maternal health, its independent impact on neonatal outcomes remains insufficiently evaluated.
Methods: A retrospective controlled study was conducted on 260 pregnant women with GDM treated at a tertiary hospital in Hubei Province, China (September 2020–June 2023). Participants were assigned to a control group receiving routine obstetric care (n = 60) or an intervention group receiving structured continuity of care (n = 200). The intervention included diet management, exercise therapy, psychological support, digital health education, and postpartum follow-up. Primary outcomes were neonatal indicators, including Apgar scores, preterm birth, macrosomia, low birth weight, neonatal distress, and NICU admission.
Results: The continuity of care group showed significantly improved neonatal outcomes compared to the control group: preterm birth (3.0% vs. 23.3%, P<.001), macrosomia (0.5% vs. 15.0%, P<.001), low birth weight (1.0% vs. 21.7%, P<.001), Apgar score ≤ 7 at 1 minute (1.5% vs. 11.7%, P<.001), and NICU admission (9.0% vs. 56.7%, P<.001). Rates of neonatal organ injury, fetal distress, and amniotic fluid contamination were also significantly lower in the intervention group.
Conclusion: Continuity of care significantly improves neonatal health in GDM pregnancies by reducing preterm delivery, abnormal birth weight, NICU transfer, and early neonatal complications. These findings suggest that continuity-based care should be integrated into routine GDM management to enhance perinatal outcomes and support mother-infant safety.
Keywords:
Gestational diabetes mellitus (GDM); Continuity of care; Neonatal outcomes; NICU admission; Preterm birth; Macrosomia; Integrated perinatal careData Availability Statement
The datasets analyzed during the current study are not publicly available due to patient confidentiality but are available from the corresponding author on reasonable request and with appropriate institutional approvals.
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