Gestational diabetes mellitus and neonatal complications: Macrosomia, neonatal hypoglycemia and shoulder dystocia

Gestational diabetes mellitus (GDM) is a common metabolic disorder of pregnancy associated with important neonatal complications. The primary adverse outcomes include macrosomia, neonatal hypoglycemia and shoulder dystocia, all of which are closely related to maternal hyperglycemia and fetal hyperinsulinism. This narrative review evaluates recent evidence published between 2020 and 2025. Studies consistently demonstrate that GDM increases the risk of macrosomia by two- to five-fold (AMERICAN DIABETES ASSOCIATION, 2024), predisposes neonates to early hypoglycemia due to persistent hyperinsulinism (RODRIGUEZ; CHEN; BRACKEN, 2024), and contributes to shoulder dystocia secondary to excessive fetal growth (ACOG, 2018). Early diagnosis, strict glycemic control and individualized delivery planning remain essential for reducing neonatal morbidity.