Understanding Gestational Diabetes: The Interplay of Psychosocial Factors and Neonatal Outcomes

Gestational Diabetes and Psychosocial Factors

Abstract

Background: Gestational diabetes mellitus (GDM) is a significant public health issue in low- and middle-income countries (LMICs) like Pakistan, driven by urbanization, dietary shifts, and socioeconomic disparities. It increases the risk of maternal and neonatal complications and is influenced by psychosocial and cultural factors.
Objective: To explore the medical, psychosocial, and cultural factors impacting GDM management and neonatal outcomes in a low-resource setting, using a case study approach.
Methods: A 30-year-old gravida 2, para 1 woman diagnosed with GDM at 24 weeks of gestation was studied. Data collection included clinical observations, structured interviews, and medical record reviews. A multidisciplinary care model comprising dietary modifications, carbohydrate counting, blood glucose monitoring, and basal-bolus insulin therapy was employed. Barriers such as financial constraints and cultural dietary practices were addressed through community health worker involvement. Outcomes were evaluated through glycemic control, delivery mode, neonatal health, and maternal psychological status.
Results: The patient achieved glycemic control with an average fasting glucose of 110 mg/dL post-intervention. The baby was delivered vaginally at 39 weeks, weighing 3.5 kg with no complications. Postpartum anxiety was reported but remained untreated due to limited mental health resources.
Conclusion: Early diagnosis, multidisciplinary care, and community support yielded favorable neonatal outcomes despite financial and psychosocial barriers. Integrating mental health services into GDM care frameworks is critical in LMICs.