Abstract
Pregnancies affected by both pregestational and gestational diabetes mellitus carry
an increased risk of adverse maternal and neonatal outcomes. While the risks associated
with diabetes in pregnancy have been well documented and span across all trimesters,
maternal and neonatal morbidity have been associated with select third-trimester complications.
Further, modifiable risk factors have been identified that can help improve pregnancy
outcomes. This review aims to examine the relationship between select third-trimester
complications (large for gestational age, intrauterine fetal demise, hypertensive
disorders of pregnancy, preterm birth, perineal lacerations, shoulder dystocia, and
cesarean delivery) and the aforementioned modifiable risk factors, specifically glycemic
control, blood pressure control, and gestational weight gain. It also highlights how
early optimization of these modifiable risk factors can reduce adverse maternal, fetal,
and neonatal outcomes.
Key Points
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Diabetes mellitus in pregnancy increases the risk of third-trimester complications.
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Modifiable risk factors exist for these complications.
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Optimizing these modifiable risk factors improves maternal and neonatal outcomes.
Keywords
diabetes in pregnancy - diabetes mellitus - hypertension - gestational weight gain
- glycemic control - fetal demise in utero - cesarean section - perineal lacerations
