What are the main risk factors for Gestational Diabetes Mellitus in poorer nations?
Gestational diabetes mellitus (GDM) is a common pregnancy complication in low- and middle-income countries (LMICs). The main risk factors are similar to those in wealthier nations, but certain factors like urban living and limited healthcare access may play a bigger role. A 2025 systematic review of 47 studies in LMICs identified the strongest risk factors 3.
What the research says
A large 2025 systematic review and meta-analysis of 47 studies from low- and middle-income countries found that several factors significantly increase GDM risk 3. These include maternal age 30 or older, having multiple pregnancies (multiparity), living in an urban area, being overweight or obese before pregnancy (BMI ≥25 kg/m²), having a family history of diabetes, having had GDM in a previous pregnancy, having pre-hypertension or preeclampsia, having polycystic ovary syndrome (PCOS), and being physically inactive 3. Another review of African populations reported a pooled GDM prevalence of 12.62% and noted that research is concentrated in a few countries, with limited regional collaboration 1. A study in Iran found that family history of diabetes, previous GDM, and maternal age were independent risk factors for both early- and late-onset GDM 9. Older studies also confirm that obesity, family history, and prior GDM are consistent risk factors 1011.
What to ask your doctor
- Given my age, weight, and family history, what is my personal risk for GDM?
- Should I be screened for GDM early in pregnancy because I have risk factors?
- What lifestyle changes (like diet or physical activity) can I make to lower my GDM risk?
- If I had GDM before, what special monitoring do I need in this pregnancy?
- Are there local programs or resources to help manage GDM risk in our community?
This question is drawn from common patient questions about Diabetes & Endocrinology and answered using cited medical research. We do not provide individualized advice.