Multivariate Analysis of Gestational Diabetes Risk Factors in a North African Population: A Call for Targeted Maternal Health Interventions

Abstract: Gestational Diabetes (GD) is a multifactorial condition influenced by demographic, anthropometric and obstetric determinants. Identifying predictive factors is essential to anticipate the disorder, guide prevention strategies and reduce maternal and neonatal complications. To assess the risk factors associated with GDM in pregnant women in the Marrakech-Safi region, in order to fill a gap in national data. A retrospective cross-sectional study was conducted on 331 women (202 with GDM and 129 without GDM). Data collected included sociodemographic and clinical characteristics: maternal age, pregestational Body Mass Index (BMI), parity, obstetric history, family history of diabetes and blood type. Multivariate logistic regression was applied, with significance set at p < 0.05. Mean maternal age was 27 years, with 17% of participants aged ≥ 35 years. Multivariate analysis identified as independent factors for GDM: Maternal age 26-35 years (aOR = 2.58; CI95% [1.37-4.88]) and ≥ 35 years (aOR = 4.37; CI95% [1.88-10.14]), history of miscarriage (aOR = 2.47; CI95% [1.18-5.15]), multiparity (2 pregnancies: aOR = 31.62; ≥ 3 pregnancies: aOR = 36.40) and family history of diabetes (aOR = 2.81; CI95% [1.56-5.07]). Blood groups A (aOR = 0.29; CI95% [0.12-0.67]) and O (aOR = 0.39; CI95% [0.18-0.87]) were associated with a lower risk of GDM compared to group B. BMI was not significantly associated. Advanced maternal age, multiparity, history of miscarriage and family history of diabetes are major determinants of GDM in the Marrakech-Safi region. The protective association observed for blood groups A and O needs to be confirmed by further studies. These results underline the need for early screening and targeted preventive strategies, adapted to local resources, to improve maternal and neonatal outcomes.