STUDY OF ASSOCIATION BETWEEN POLYHYDRAMNIOS AND GLUCOSE INTOLERANCE IN PREGNANCY

Abstract

Background: Polyhydramnios is associated with adverse maternal and perinatal outcomes and may be an important indicator of underlying gestational diabetes mellitus (GDM). This study aimed to determine the frequency of GDM among pregnant women with polyhydramnios and compare maternal and neonatal outcomes between women with and without GDM. Methods: A hospital-based prospective observational study was conducted among 50 pregnant women with polyhydramnios attending the Department of Obstetrics and Gynaecology, SVIMS–SPMCW, Tirupati, India. Eligible women with singleton pregnancies beyond 20 weeks of gestation and an amniotic fluid index (AFI) >24 cm or single deepest pocket >7 cm were enrolled consecutively. Participants underwent screening for glucose intolerance using oral glucose challenge testing followed by oral glucose tolerance testing when indicated. Based on glucose status, participants were categorized into GDM and non-GDM groups and followed until delivery. Maternal characteristics, obstetric complications, mode of delivery, and neonatal outcomes were compared. Results: Among the 50 women with polyhydramnios, 18 (36.0%) were diagnosed with GDM, of whom 16 (32.0%) required insulin therapy and 2 (4.0%) were managed with medical nutrition therapy. Maternal age ≥30 years was significantly associated with GDM (66.7% vs. 26.3%). Women with GDM had significantly higher mean maternal age (30.44±2.01 vs. 27.75±3.10 years) and delivered infants with higher mean birth weights (3.36±0.47 vs. 2.89±0.42 kg) compared with non-GDM women. No significant differences were observed in parity, PROM, preeclampsia, mode of delivery, or low birth weight between the groups. Conclusions: More than one-third of pregnancies complicated by polyhydramnios had GDM. Advanced maternal age and higher neonatal birth weight were significantly associated with GDM. Routine screening for GDM in women with polyhydramnios may facilitate early diagnosis and timely intervention, thereby improving maternal and neonatal outcomes.