COMPARATIVE ANALYSIS OF THE COURSE OF PREGNANCY AND CHILDBIRTH IN WOMEN WITH OBESITY AND GESTATIONAL DIABETES MELLITUS BEFORE AND DURING MILITARY AGGRESSION

Introduction. Researching the issue of gestational diabetes mellitus (GDM) in women with obesity during the military aggression in Ukraine on the example of the Kharkiv region and comparing the obtained data with the pre-war period is a relevant task of modern obstetrics. The purpose of the study is to conduct a comparative analysis of the course of pregnancy and childbirth in women with obesity, whose gestational period was complicated by the development of diabetes mellitus, before and during military aggression in the Kharkiv region.Material and methods. The documentation of reports of the Maternity Department of the Communal Non-Profit Enterprise of Kharkiv Regional Council “Regional Clinical Hospital” was analyzed starting from 2020, taking into account the total number of births (separately before and during military aggression).Research results and their discussion. Before the start of the military aggression, the number of births in 2020-2021 was 4,102, of which births in pregnant women with obesity accounted for 157 cases, which corresponds to 3.83%, and births in women with gestational diabetes – 188 (4.58%). During the war (2022-2023), there were 2,201 births, of which 108 (4.91%) were in pregnant women with obesity, 159 (7.22%) – with GDM. Among women with obesity who developed GDM during pregnancy, 112 cases (2.73%) were recorded in 2020-2021 (first group) and 89 (4.04%) – in 2022-2023 (second group), which indicates a 1.48-fold increase in the number of pregnant women with GDM on the background of obesity.Delivery by caesarean section in pregnant women with obesity and GDM occurred in 44 (39.8%) women before the start of the military aggression, and in 41 (46.1%) – during the war. 35 (31.3%) and 24 (30%) infants weighing more than 4,000 g were born, respectively. Diabetic fetopathy was diagnosed in 36 (32.1%) cases before the war and in 32 (36%) during the military actions. 46 (41.1%) babies were born in a state of asphyxia of varying severity before the war and 43 (48.3%) – during the war. Other complications of newborns included shoulder dystocia due to macrosomia in 16 (14.3%) and 14 (15.7%) infants, respectively, before and during the military actions; hypoglycemia in 21 (18.8%) and 18 (20.2%), jaundice in 34 (30.4%) and 29 (32.6%), respiratory distress syndrome in 11 (9.8%) and 9 (10.1%), CNS lesions in 15 (13.4%) and 11 (12.3%), respectively.Conclusions. Among extragenital pathology in women with obesity and GDM, the frequency of hypertensive disease (39.3%), thyroid gland pathology (40.4%), anemia (20.2%), and vision pathology (19.1%) increased during martial law. Among obstetric pathologies, the number of premature births, macrosomia, diabetic fetopathy, and caesarean sections increased. The data obtained in our study provide a better understanding of the impact of GDM in women with obesity on obstetric and perinatal complications and their differences before and during the military aggression.