NMR based clinical metabolomics for predicting onset of Gestational diabetes mellitus (GDM) during first trimester: a pilot study in North Indian Population

Gestational diabetes mellitus (GDM), defined as hyperglycemia first identified during pregnancy in the second or third trimester, is a growing global concern due to the rising prevalence of obesity and diabetes. GDM is associated with significant short- and long-term health complications for both women and their offspring. During pregnancy, it increases the risks of obstetric issues such as gestational hypertension, dystocia, postpartum hemorrhage, and preterm birth, alongside fetal complications like macrosomia and congenital malformations. Additionally, GDM has intergenerational consequences, predisposing women and their children to chronic conditions including type 2 diabetes, obesity, cardiovascular disease, and dyslipidemia later in life. South Asian women have the highest global prevalence of GDM, hypothesized to result from genetic predispositions, higher adiposity, and dietary differences. However, this population remains underrepresented in GDM research, with only seven metabolomic studies to date, most involving fewer than 20 cases. This study seeks to identify serum metabolites associated with GDM and elucidate metabolic pathways distinguishing GDM from non-GDM pregnancies in North Indian women.