The Association between Gestational Diabetes Mellitus and Infections in Pregnancy—Systematic Review and Meta-Analysis

Abstract

We conducted a systematic review and meta-analysis to evaluate the association between gestational diabetes mellitus and infections during pregnancy. We included cross-sectional, case-control, cohort studies and clinical trials, evaluating the frequency of infections in women with and without gestational diabetes mellitus. A search was conducted in Embase, PubMed, and Web of Science electronic databases and by manually searching references, until 23 March 2022, resulting in 16 studies being selected for review, with 111,649 women in the gestational diabetes mellitus group, and 1,429,659 in the controls. Cochrane’s Q test of heterogeneity and I² were used to assess heterogeneity. Pooled odds ratio (OR) was calculated. Funnel plots and Egger test were used for assessment of publication bias. The results showed a significant association between gestational diabetes mellitus and infections (pooled-OR 1.3 95% CI [1.2–1.5]). Sub-analyses showed a significant association for urinary tract infections (pooled-OR of 1.2 95% CI [1.1–1.3]), bacterial infections (pooled-OR were 1.2 95% CI [1.1–1.4]), and SARS-CoV-2 (pooled-OR 1.5 95% CI [1.2–2.0]) but not to gingivitis or vaginal candidiasis. The results underscore the significance of acknowledging gestational diabetes mellitus as a risk factor for infections.

Missed Diagnosis of Gestational Diabetes Mellitus Due to Selective Screening: Evidence from a Cross-Sectional Study in the West Nile Sub-Region, Uganda

“…A study in South India showed that pregnant women with GDM were three (3) times more likely to develop UTI than their counterparts who did not have GDM (P = 0.051, OR = 3.2), 31 which was consistent with a systemic review that showed similar results where there was a significant association between GDM and UTI but not vaginal candidiasis. 32 The explanation for this could be that gestational diabetes compromises the immune system, predisposing it to infections such as UTI. 33,34 One of our limitations was the lack of funding, as we were unable to follow our participants to study maternal and newborn outcomes.…”

The Maternal Microbiome and Gestational Diabetes Mellitus: Cause and Effect

“…Offspring exposed to GDM have an increased risk of macrosomia, fetal growth restriction, preterm birth, and neonatal metabolic dysfunction. In the long-term both mothers and babies have an increased risk of developing metabolic diseases such as type 2 diabetes mellitus (T2DM) and cardiovascular disease [ 5 , 6 , 7 , 8 ]. Despite a well-established association between GDM and unfavorable maternal and neonatal outcomes [ 5 , 6 , 7 ], the mechanisms that underlie this link remain incompletely understood.…”