Abstract
Background: Gestational diabetes mellitus (GDM) is a common metabolic complication of pregnancy with implications that extend beyond glycemic control and obstetric outcomes. Health-related quality of life (HRQoL) is an important patient-reported outcome that may reflect the broader physical, psychological, social, and environmental burden of GDM. This study aimed to evaluate HRQoL among pregnant women with GDM compared with women with uncomplicated pregnancies and to explore demographic, obstetric, and glycemic factors associated with HRQoL outcomes. Methods: A cross-sectional comparative observational study was conducted at the Athens Naval Hospital. The study included 111 pregnant women aged 20–45 years with GDM and 112 pregnant women without known pathological conditions. HRQoL was assessed using the WHOQOL-BREF questionnaire. Non-parametric statistical tests included the Mann-Whitney U test, Friedman test, Kruskal-Wallis test, and Spearman’s correlation coefficient. Adjusted general linear models were used to examine the association between GDM status and HRQoL after accounting for selected measured covariates. Results: Women with GDM had significantly lower HRQoL scores than controls across all WHOQOL-BREF domains, including physical health, psychological health, social relationships, environment, and overall quality of life. Effect sizes ranged from small to moderate (r = 0.23–0.35). Among women with GDM, the Environment domain showed the lowest relative score, followed by Psychological Health, Social Relationships, and Physical Health. Fasting glucose showed initial negative associations with Psychological Health and Social Relationships, but these did not remain significant after Bonferroni correction. In adjusted models, GDM status remained significantly associated with lower HRQoL across all outcomes. Conclusions: GDM was associated with lower HRQoL during pregnancy after adjustment for selected measured covariates. These findings support consideration of maternal HRQoL alongside glycemic monitoring and obstetric surveillance in antenatal GDM care.