Maternal and Fetal Outcomes in Hyperglycemia in Pregnancy

Background: Hyperglycemia in pregnancy (HIP), particularly gestational diabetes mellitus (GDM), is one of the most common metabolic disorders complicating pregnancy and is associated with increased maternal and neonatal morbidity. Poor glycemic control can lead to adverse maternal outcomes such as urinary tract infections, vaginal candidiasis, preeclampsia, polyhydramnios, preterm labor, and premature rupture of membranes (PROM), while fetal complications include macrosomia, respiratory distress syndrome, hyperbilirubinemia, and neonatal intensive care unit (NICU) admission. Early diagnosis and appropriate management are essential to improve pregnancy outcomes.

Objectives: To assess the maternal outcomes associated with hyperglycemia in pregnancy, including vaginal candidiasis, symptomatic urinary tract infection (UTI), PROM, preterm labor, polyhydramnios, and preeclampsia, and to evaluate fetal outcomes in terms of macrosomia, hyaline membrane disease, and hyperbilirubinemia.

Materials and Methods: A prospective observational study was conducted over 18 months among 95 pregnant women diagnosed with hyperglycemia in pregnancy attending the antenatal clinic at Dr. B. R. Ambedkar Medical College and Hospital. Women with singleton pregnancies up to 28 weeks' gestation and a 2-hour plasma glucose level >140 mg/dL following a 75-g oral glucose challenge test were included. Demographic, clinical, laboratory, obstetric, and neonatal data were collected and analyzed using SPSS version 21. Statistical significance was considered at p < 0.05.

Results: Among the 95 participants, 52.6% were older than 30 years. Vaginal delivery was observed in 54.7% of cases, while 45.3% underwent lower segment cesarean section. The most common maternal complications were vaginal candidiasis (36.8%) and urinary tract infection (23.2%), followed by polyhydramnios, preterm labor, PROM, and preeclampsia. Fetal complications included hyaline membrane disease (11.6%), hyperbilirubinemia (9.5%), and macrosomia (5.3%). Polyhydramnios demonstrated a statistically significant association with mean OGTT values (p = 0.009), whereas no significant associations were found between OGTT values and other maternal or fetal complications.

Conclusion: Hyperglycemia in pregnancy remains an important contributor to maternal and neonatal morbidity. Universal screening, early diagnosis, strict glycemic control, and multidisciplinary management can significantly reduce adverse pregnancy outcomes. Long-term follow-up of both mothers and offspring is essential to prevent future metabolic disorders and improve overall maternal and child health