Adverse Obstetric and Neonatal Outcomes in Maternal Diabetes: Prediction by Glucose-to-Potassium Ratio

INTRODUCTION: The aim of this study is to investigate whether the glucose-to-potassium ratio (GPR) can predict adverse obstetric and neonatal outcomes in pregnant women diagnosed with diabetes.
METHODS: This retrospective observational study included 80 pregnant women diagnosed with pregestational or gestational diabetes, as well as 120 healthy pregnant women, between 2023 and 2025. GPR was calculated by dividing the glucose level by the potassium level in the venous blood sample taken at the time of delivery. Receiver Operating Characteristic curves were constructed to evaluate the predictive value of GPR for adverse obstetric and neonatal outcomes.
RESULTS: In maternal diabetes, multiparity and comorbid conditions were found to be higher. The gestational age at delivery was similar in both groups; however, the birth weight of neonates born to diabetic mothers was statistically higher. The NICU admission and adverse obstetric outcomes were higher in the case group. The median GPR level was 23.4 in the diabetes group and 20.3 in the control group (p < 0.001). When all participants were analysed, the optimal cut-off value of GPR for predicting NICU admission was found to be 21.7 (AUC 0.583, Sensitivity 55.3%, Specificity 55.1%, 95% CI 0.505–0.667, p = 0.043). Glucose levels were found to be statistically significant in predicting NICU admission and adverse obstetric outcomes (p = 0.017 and p = 0.005, respectively). However, these markers did not show predictive value within the diabetic group.
DISCUSSION AND CONCLUSION: GPR and hyperglycemia may be associated with adverse obstetric outcomes.