Publication:

From diagnosis to delivery: a retrospective analysis of diabetes in pregnancy at a tertiary care centre in South India

Background Diabetes in pregnancy is increasing globally, driven by rising obesity and lifestyle changes. In India, gestational diabetes mellitus (GDM) affects up to 15–20% of pregnancies and contributes substantially to obstetric and neonatal morbidities. Early identification and standardized management pathways are essential. Our objective is to review the clinical patterns, management strategies, and maternal–fetal outcomes of diabetic pregnancies, highlighting key trends useful for improving antenatal care pathways.

Methods A retrospective descriptive study was conducted among 55 pregnant women diagnosed with diabetes and managed between January and December 2025 at a tertiary care institution in South India. Maternal demographic details, comorbidities, treatment modalities, obstetric complications, and pregnancy outcomes were obtained from medical records and analyzed descriptively.

Results Most women were aged 20-30 years (50.9%) and were primiparous (74.5%). A family history of diabetes was present in 24 (43.6%). Diabetic pregnancies showed diverse comorbid profiles, with hypertensive disorders, thyroid dysfunction, and ART conception frequently co-existing. A significant proportion (81.8%) required pharmacologic therapy for diabetes. Growth abnormalities showed distinct maternal risk patterns LGA linked to endocrine immune factors, while FGR clustered around placental dysfunction (PE, PIH, ART, twins). A sizeable proportion (40%) delivered before term due to maternal or fetal indications, highlighting the need for anticipatory delivery planning. Delivery decisions were influenced predominantly by maternal complications and fetal status. Emergency LSCS was largely driven by pre-eclampsia and fetal distress, showing how rapidly clinical status can evolve in diabetic pregnancies.

Conclusion Maternal and fetal outcomes in diabetic pregnancies are strongly influenced by associated comorbidities such as hypertensive disorders, hypothyroidism, and assisted conception. Early diagnosis, multidisciplinary antenatal surveillance, and individualized delivery planning are essential to improve pregnancy outcomes in diabetic women.