Abstract
<title>Abstract</title> <p> <bold>Objective:</bold> To compare antepartum fetal well-being parameters and perinatal outcomes in pregnancies complicated by gestational diabetes mellitus (GDM) or pregestational diabetes mellitus (PGDM) with healthy pregnancies, and to assess the relationship between antenatal monitoring and neonatal acid–base status at birth. <bold>Study Design:</bold> This prospective observational study included 152 pregnant women: 61 with GDM, 25 with PGDM, and 66 controls. Antepartum evaluation included fetal biometry, amniotic fluid assessment, umbilical artery and middle cerebral artery Doppler indices, and computerized cardiotocography. Delivery mode and neonatal outcomes, including umbilical cord blood gas analysis, were compared among groups. <bold>Results:</bold> GDM and PGDM pregnancies showed lower umbilical artery pulsatility index values than controls (p<0.001). Middle cerebral artery pulsatility index was slightly lower in GDM (p=0.028). Some computerized cardiotocography parameters differed modestly among groups. Umbilical cord blood gas values showed clearer differences, especially in PGDM pregnancies. Cord pH was lower in PGDM and after vaginal delivery. pO₂ progressively decreased from controls to GDM and PGDM, whereas pCO₂ increased. Lactate levels were higher in PGDM pregnancies and vaginal deliveries. <bold>Conclusions:</bold> Conventional antepartum monitoring showed limited differences between diabetic and healthy pregnancies, while neonatal acid–base status differed more clearly. A multimodal approach may improve fetal assessment and risk stratification. </p>