Received May 25, 2026
Accepted June 18, 2026

Objective: To evaluate risk factors for gestational diabetes mellitus (GDM) in pregnancies achieved after in vitro fertilization (IVF), with emphasis on pre-pregnancy obesity, polycystic ovary syndrome (PCOS), metabolic parameters, body composition assessed by bioelectrical impedance analysis (BIA), and circulating miRNA-29 expression levels. Methods: This retrospective cohort study included 210 pregnant women; 110 conceived via IVF and 100 controls with spontaneous pregnancies. Clinical, laboratory, BIA, and serum miRNA-29a/miRNA-29b data were analyzed. BIA parameters included body fat percentage (BF%), visceral fat area (VFA, cm²), skeletal muscle mass (SMM, kg), and phase angle (PA, degrees). miRNA-29a/miRNA-29b expression was quantified by quantitative RT-PCR. Associations with GDM were assessed by logistic regression and Pearson correlation analyses. Results: GDM incidence was significantly higher in the IVF group (27.3% vs 14.0%, P=0.01). Pre-pregnancy obesity (OR=3.21; 95% CI: 1.68–6.13) and elevated BIA body fat percentage (OR=2.84; 95% CI: 1.43–5.64) were independently associated with GDM. Women with GDM exhibited significantly lower serum miRNA-29a and miRNA-29b expression (both P<0.001). miRNA-29a showed good discriminatory capacity for GDM (AUC=0.81; 95% CI: 0.72–0.90). Significant negative correlations were observed between miRNA-29a expression and fasting glucose (r=?0.48), BMI (r=?0.43), and VFA (r=?0.39). Conclusion: GDM in IVF pregnancies is associated with pre-existing metabolic disturbances, adverse body composition, and downregulation of circulating miRNA-29. Integrating BIA and miRNA profiling into preconception evaluation may improve early risk stratification in this high-risk population.