A Comparative Cross-Sectional Study Between Gestational Diabetes Mellitus and Preeclampsia: Medication Adherence, Depression and Quality of Life

Background: Gestational diabetes mellitus (GDM) and preeclampsia (PE) are two of the most prevalent high-risk pregnancy problems, with significant consequences for maternal health, emotional well-being, and quality of life (QoL). Aim: This study aimed to compare the medication adherence, depression, and QoL among women with GDM and PE. Patients and Methods: This was a cross-sectional study conducted in 1306 women with GDM and PE. A total of 7 hospitals were included across Punjab, Pakistan, conducted between November 2024 to June 2025. Data were collected using the Medication Adherence Report Scale (MARS-5), Patient Health Questionnaire-9 (PHQ-9) and WHOQOL-BREF. Statistical analyses, including frequency, Mann–Whitney U -tests and Kruskal–Wallis test to compare the median across different factors. Exploratory data analysis (EDA) was used to assess the relation between medication adherence, depression, and QoL for different conditions. Linear regression models were employed to assess the medication adherence, depression, and QoL, among women with GDM and PE. Results: The preeclamptic women showed higher medication adherence than those with GDM (Median=14, Q1-Q3=12-16, p=0.012 ). Depression scores were significant in physical health domain of QoL in preeclamptic patient ( p=0.001 ). QoL scores ( p< 0.05 ) were higher in physical, psychological, social, and environmental domains, particularly among women with GDM than those with PE. Overall education level, parity, and social support were significant ( p< 0.05 ) predictor of adherence and QoL across both conditions. Conclusion: Preeclamptic women were more likely to take their medication as prescribed than GDM women. However, our study highlights the depression as a predictor of physical health in preeclamptic patients with WHOQOL scores while women with GDM reported a better overall QoL than PE. Keywords: depression, gestational diabetes mellitus, medication adherence, preeclampsia, quality of life