The problem of gestational diabetes and maternal obesity in the Kharkiv region during the war

The objective: to determine the epidemiological data, risk factors, and pathogenesis of gestational diabetes mellitus (GDM) in pregnant women with obesity, and to examine modern approaches to its treatment in the context of the war in the Kharkiv region. Material and methods. This study represents an analysis of the epidemiological data of pregnant women with obesity and gestational diabetes who were observed at the Communal Non-Commercial Enterprise of the Kharkiv Regional Council “The Regional Clinical Hospital” over the last 4 years (2 years before the war and 2 years during the war). These data were compared with modern literature on risk factors, pathogenesis, diagnosis, and treatment of GDM in obese women. Results. During the war, the level of obstetric pathology increased to 90-100%, while the threat of premature birth doubled to almost 40%. Childbirth for pregnant women with GDM and obesity often ends in cesarean section due to fetal macrosomia, fetopathy, and labor abnormalities. Therefore, gestational diabetes and obesity are complex conditions that require a comprehensive treatment strategy from an interdisciplinary team, including obstetrician-gynecologists, endocrinologists, ophthalmologists, neuropathologists, neonatologists, laboratory technicians, and pharmacists. Such a comprehensive approach is typically only available in multidisciplinary clinical hospitals, which are necessary to achieve optimal treatment results and prevent further complications. Conclusions. Although the number of treated pregnant women during martial law at the Kharkiv Regional Hospital almost halved compared to pre-war times, the number of pregnant women with extragenital pathology increased from 70.6% to 97.2%. Endocrine pathology occupies the first place among somatic diseases in pregnant women (24.3%), with gestational diabetes and obesity leading. The frequency of these conditions increased during martial law to 37% and 31%, respectively, worsening the condition of both mother and fetus and increasing the percentage of operative deliveries. It is necessary to improve preventive and therapeutic measures for GDM and obesity in pregnant women, taking into account their psycho-emotional state during the war in frontline regions, which will be the next goal of our work.