Prevalence and Clinical Profile of Cardiac and Endocrine Complications in Pregnancy: A Hospital-Based Observational Study from a Tertiary Care Center in South India

Pregnancy is a complex physiological state characterized by significant anatomical, cardiovascular, metabolic, and endocrine adaptations that support foetal development and maternal well-being. These physiological changes include increased cardiac output, expanded plasma volume, and alterations in hormonal regulation that influence glucose metabolism and thyroid function. Although such changes are essential for maintaining pregnancy, they may unmask previously undiagnosed conditions or exacerbate pre-existing disorders, particularly those affecting the cardiovascular and endocrine systems [1].

Cardiovascular disorders are increasingly recognized as a leading indirect cause of maternal morbidity and mortality worldwide. Pregnancy imposes substantial hemodynamic stress on the cardiovascular system, including a 30–50% increase in cardiac output and blood volume, which can precipitate complications such as hypertensive disorders, arrhythmias, and peripartum cardiomyopathy in susceptible women. These conditions contribute significantly to adverse maternal outcomes, including heart failure, stroke, and increased hospitalization rates during pregnancy [2]. Hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia, remain among the most common cardiovascular complications and are strongly associated with maternal organ dysfunction and adverse foetal outcomes such as intrauterine growth restriction and preterm birth [3].

Endocrine disorders represent another major category of medical complications during pregnancy. Gestational diabetes mellitus (GDM) is one of the most common endocrine disorders and is defined as glucose intolerance first recognized during pregnancy. The global prevalence of GDM varies widely, ranging from approximately 1% to 28% depending on population characteristics, screening criteria, and ethnic variations [4]. In South Asian populations, the burden of GDM is particularly high due to genetic susceptibility, lifestyle factors, and increasing maternal age. Uncontrolled gestational diabetes is associated with significant maternal and neonatal complications, including macrosomia, neonatal hypoglycemia, cesarean delivery, and long-term metabolic disorders in both mother and child [5].

Thyroid dysfunction is another frequently encountered endocrine disturbance during pregnancy. Epidemiological studies indicate that thyroid disorders affect a considerable proportion of pregnant women, with overt hypothyroidism occurring in approximately 2–3% of pregnancies and subclinical hypothyroidism occurring in up to 15% depending on diagnostic criteria [6]. In India, recent hospital-based studies estimate that nearly 10–13% of pregnant women experience thyroid dysfunction during gestation, highlighting the substantial burden of endocrine abnormalities in this population [7]. Untreated thyroid dysfunction has been associated with adverse maternal and foetal outcomes, including preeclampsia, miscarriage, preterm delivery, and impaired foetal neurodevelopment [8].

The interaction between cardiovascular and endocrine disorders during pregnancy further complicates maternal health outcomes. For instance, endocrine abnormalities such as thyroid dysfunction and gestational diabetes have been shown to increase the risk of cardiovascular complications during pregnancy through mechanisms involving insulin resistance, systemic inflammation, and endothelial dysfunction. Emerging evidence suggests that women with gestational diabetes are at increased risk of thyroid abnormalities and long-term cardiovascular disease, emphasizing the importance of integrated screening and management strategies [9].

Despite advancements in maternal healthcare and antenatal screening programs, the prevalence of pregnancy-related medical complications remains substantial in many low- and middle-income countries. In India, although institutional deliveries and antenatal care coverage have improved significantly, high-risk pregnancies associated with metabolic and cardiovascular disorders continue to pose serious challenges to maternal and neonatal health outcomes. Early identification of these conditions through systematic screening and multidisciplinary management is therefore critical for reducing maternal morbidity and improving perinatal outcomes [10].

Hospital-based observational studies play an important role in understanding the epidemiological patterns and clinical characteristics of pregnancy-related medical disorders in specific populations. Such studies provide valuable insights into disease prevalence, associated risk factors, and clinical outcomes, which are essential for developing targeted prevention strategies and optimizing maternal healthcare services. Therefore, the present study was undertaken to evaluate the prevalence and clinical profile of cardiac and endocrine complications among pregnant women attending a tertiary care hospital in South India, with the aim of contributing to improved clinical management and maternal health outcomes.

MATERIALS AND METHODS

MATERIALS

The present study utilized a range of clinical, laboratory, and diagnostic resources to evaluate cardiac and endocrine complications among pregnant women. Standardized clinical documentation tools and validated diagnostic investigations were used to ensure accurate data collection and reliable assessment of maternal and foetal outcomes.

Study Setting

The study was conducted at Singareni Collieries Company Limited (SCCL) Main Hospital, Kothagudem, a tertiary care referral hospital equipped with specialized departments including obstetrics and gynecology, cardiology, endocrinology, neonatology, and clinical laboratory services. The hospital caters to a diverse population from both rural and semi-urban areas, providing comprehensive antenatal care and high-risk pregnancy management.

Study Population

The study population consisted of pregnant women attending the antenatal clinic (ANC) and obstetric inpatient services of SCCL Main Hospital during the study period. Women diagnosed with or suspected to have cardiovascular or endocrine complications during pregnancy were considered eligible for evaluation.

Clinical Materials and Diagnostic Resources

The following materials and diagnostic tools were used during the study:

Clinical Assessment Tools

• Structured case record forms (CRFs) for systematic data collection
• Standardized antenatal examination charts
• Blood pressure monitoring equipment
• Body mass index (BMI) assessment tools

Laboratory Investigations

Laboratory investigations were conducted using standard hospital laboratory facilities and included:

• Thyroid function tests (TFTs): Thyroid-stimulating hormone (TSH), Free triiodothyronine (FT3), and Free thyroxine (FT4)
• Glucose metabolism tests: Fasting blood glucose, Oral Glucose Tolerance Test (OGTT), and glycated hemoglobin (HbA1c)
• Routine antenatal investigations: Hemoglobin estimation, blood grouping, urine analysis, and infectious disease screening

Cardiac Diagnostic Investigations

• Electrocardiography (ECG) for detection of arrhythmias and cardiac conduction abnormalities
• Echocardiography (ECHO) for identification of structural and functional cardiac abnormalities, including cardiomyopathy and valvular disorders
• Cardiac biomarkers such as troponins and B-type natriuretic peptide (BNP) when clinically indicated

Obstetric Imaging

• Doppler ultrasonography for evaluation of foetal growth parameters, uteroplacental circulation, and amniotic fluid index.

METHODS

Study Design

This investigation was conducted as a hospital-based prospective observational study. The prospective design enabled continuous monitoring of pregnant women from antenatal enrollment through subsequent follow-up visits, allowing detailed assessment of the development and progression of cardiac and endocrine complications during pregnancy.

Study Duration

The study was carried out over a six-month period, which included patient recruitment, clinical monitoring, data compilation, statistical analysis, and interpretation of results.

Participant Recruitment and Sampling Technique

A consecutive sampling method was used for patient recruitment. All pregnant women attending the antenatal clinic during the study period who satisfied the eligibility criteria were enrolled until the required sample size was achieved.

A minimum of 200 participants were included in the study. The sample size was determined based on the average antenatal clinic attendance at the study hospital and the expected incidence of cardiac and endocrine complications among pregnant women.

Inclusion Criteria

Participants were included in the study if they met the following criteria:

• Pregnant women attending antenatal care services at SCCL Main Hospital
• Patients diagnosed with or suspected to have cardiac or endocrine complications during pregnancy, including gestational hypertension, preeclampsia, gestational diabetes mellitus, thyroid dysfunction, or cardiomyopathy
• Women who provided written informed consent for participation in the study

Exclusion Criteria

Participants were excluded from the study under the following conditions:

• Pregnant women with incomplete clinical records
• Patients with previously diagnosed cardiac or endocrine disorders unrelated to pregnancy complications
• Women who were lost to follow-up during the study period

Data Collection Procedures

Data were collected using standardized case record forms designed for the study. Information obtained included demographic details, obstetric history, clinical findings, laboratory results, and maternal and foetal outcomes.

Clinical Evaluation

All participants underwent comprehensive clinical examination that included:

• Detailed obstetric history including gravidity, parity, and previous pregnancy complications
• Measurement of blood pressure and heart rate
• Assessment of body mass index
• Evaluation of symptoms such as dyspnoea, palpitations, fatigue, syncope, or peripheral oedema

Laboratory Assessment

Laboratory investigations were conducted according to standard antenatal screening protocols. Thyroid function tests were performed to detect hypo- or hyperthyroidism. Oral glucose tolerance testing and HbA1c measurement were used to identify gestational diabetes mellitus. Routine antenatal laboratory investigations were also performed to evaluate general maternal health status.

Diagnostic Imaging

Electrocardiography and echocardiography were performed when clinically indicated to identify cardiac abnormalities. Doppler ultrasonography was used to assess foetal growth, placental circulation, and amniotic fluid volume.

Statistical Analysis

Collected data were entered into a computerized database and analyzed using appropriate statistical software.

Descriptive Statistics

Descriptive statistical methods were used to summarize demographic and clinical characteristics. Continuous variables were expressed as mean ± standard deviation, while categorical variables were presented as frequencies and percentages.

Inferential Statistics

Associations between maternal risk factors and pregnancy outcomes were analyzed using:

• Chi-square test or Fisher’s exact test for categorical variables
• Independent t-test or Mann-Whitney U test for continuous variables

A p-value less than 0.05 was considered statistically significant.

Multivariate Analysis

Multivariate logistic regression analysis was performed to identify independent predictors of cardiac and endocrine complications during pregnancy. Adjusted odds ratios with 95% confidence intervals were calculated for relevant variables including maternal age, body mass index, parity, and comorbid conditions.

Ethical Considerations

The research protocol was reviewed and approved by the Institutional Ethics Committee of SCCL Main Hospital, Kothagudem. All study procedures were conducted in accordance with the ethical principles outlined in the Declaration of Helsinki.

Written informed consent was obtained from all participants after explaining the objectives and procedures of the study. Confidentiality of patient information was maintained throughout the study by anonymizing personal identifiers and restricting access to authorized research personnel only.

Participation in the study was voluntary, and participants were informed of their right to withdraw at any stage without affecting their medical care.

RESULTS AND DISCUSSION

Overview of Study Findings

This study evaluated the prevalence and clinical characteristics of cardiac and endocrine complications among pregnant women receiving antenatal care at a tertiary care hospital in South India. A total of 303 pregnant women were enrolled and systematically evaluated for demographic characteristics, maternal risk factors, clinical manifestations, and maternal–foetal outcomes associated with cardiovascular and endocrine disorders.

The results highlight the significant burden of hypertensive disorders, thyroid dysfunction, and gestational diabetes mellitus among the study population. These complications represent major contributors to maternal morbidity and adverse neonatal outcomes, emphasizing the importance of early screening and multidisciplinary clinical management during pregnancy.

Recent epidemiological studies have similarly reported an increasing prevalence of cardiometabolic disorders in pregnancy, particularly in low- and middle-income countries where antenatal screening programs are still evolving [11]. Such complications can significantly affect placental function, maternal cardiovascular adaptation, and foetal growth, thereby increasing the risk of preterm delivery and neonatal complications [12].

Demographic and Clinical Characteristics of the Study Population

As shown in Table 1, the study included 303 pregnant women whose demographic and clinical characteristics were analyzed. The age distribution indicated that the majority of participants were in the 26–35 years age group (204 participants; 67.33%), followed by 18–25 years (83 participants; 27.39%), while only 16 participants (5.28%) belonged to the 36–45 years age category. This distribution demonstrates that most pregnancies occurred during the typical reproductive age period.

Regarding body mass index (BMI), the findings presented in Table 1 indicate that 296 participants (97.69%) had normal BMI, whereas 4 participants (1.32%) were overweight and 3 participants (0.99%) were obese. The predominance of normal BMI suggests that the majority of women maintained appropriate weight status during pregnancy.

With respect to parity, Table 1 shows that primiparous women represented the largest proportion of the study population (160 participants; 52.81%), followed by nulliparous women (104 participants; 34.32%) and multiparous women (37 participants; 12.21%). This indicates that a substantial proportion of the study participants were experiencing pregnancy for the first time.

Statistical comparison of categorical variables demonstrated a significant predominance of participants in the 26–35 year age group compared with other age categories (p < 0.05). Similarly, the proportion of women with normal BMI was significantly higher than overweight and obese groups (p < 0.05). The distribution of parity also revealed a statistically significant predominance of primiparous women compared with multiparous participants (p < 0.05). These findings suggest that the study cohort primarily consisted of women within the optimal reproductive age range with normal body weight and early parity status.

The demographic characteristics summarized in Table 1 provide important insights into the maternal profile of the study population. The predominance of women within the 26–35 year age group reflects the typical reproductive age distribution observed in hospital-based obstetric studies. Although this age range is generally considered optimal for pregnancy, evidence from epidemiological studies indicates that advancing maternal age within this group may increase susceptibility to metabolic disorders such as gestational diabetes mellitus and hypertensive disorders of pregnancy due to progressive insulin resistance and endothelial dysfunction [13].

The high proportion of participants with normal BMI, as reported in Table 1, suggests that the majority of women maintained a healthy anthropometric profile during pregnancy. Maternal overweight and obesity are well-established risk factors for pregnancy complications including gestational diabetes, preeclampsia, cesarean delivery, and neonatal macrosomia. Excess maternal adiposity can also influence drug pharmacokinetics by altering drug distribution and metabolic clearance, which may impact pharmacotherapeutic management during pregnancy.

Parity distribution presented in Table 1 revealed that primiparous women constituted more than half of the study population. Primigravidity has been widely reported as a significant risk factor for hypertensive disorders of pregnancy, particularly preeclampsia. The pathophysiological mechanisms are believed to involve inadequate maternal immunological tolerance to foetal antigens and impaired placental vascular remodeling, which may lead to endothelial dysfunction and abnormal placental perfusion [14].

From a clinical pharmacy perspective, these demographic variables are important for identifying women at increased risk for pregnancy-related complications and for optimizing medication management during antenatal care. Clinical pharmacists can contribute to improved maternal health outcomes through pharmacotherapy monitoring, medication safety evaluation, and patient education aimed at promoting rational drug use and adherence to treatment during pregnancy.

Table 1: Demographic And Clinical Characteristics Of Study Participants (N = 303)

Prevalence of Cardiac Complications in the Study Population

The prevalence of cardiovascular complications observed among the study participants is summarized in Table 2. Among the 303 pregnant women included in the study, hypertensive disorders represented the most common cardiac complication, affecting 127 participants (41.91%). In contrast, arrhythmias were identified in 19 women (6.27%), while heart failure was reported in only 2 cases (0.66%). No cases of peripartum cardiomyopathy or thromboembolic disorders were recorded during the study period.

These findings indicate that hypertensive disorders constitute the dominant cardiovascular condition complicating pregnancy in the studied population. The distribution of cardiac disorders is further illustrated in Figure 1, where hypertensive disorders represent the largest proportion of cardiovascular complications compared with other cardiac conditions.

Descriptive statistical analysis demonstrated that hypertensive disorders accounted for the highest proportion of cardiovascular complications (41.91%), significantly exceeding the prevalence of other cardiac conditions observed in the study population. Chi-square comparison of the categorical variables revealed that the occurrence of hypertensive disorders was significantly higher than arrhythmias and heart failure (p < 0.05). These findings suggest a clear predominance of hypertensive disorders as the major cardiovascular complication during pregnancy within this cohort.

Cardiovascular complications remain a major contributor to maternal morbidity and mortality during pregnancy. The present study demonstrated that hypertensive disorders were the most prevalent cardiac complication, affecting nearly two-fifths of the study population. This observation is consistent with epidemiological reports indicating that hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia, represent one of the leading causes of adverse maternal outcomes worldwide.

The high prevalence of hypertensive disorders observed in this study may be attributed to complex pathophysiological mechanisms associated with abnormal placental development and maternal vascular maladaptation. Impaired trophoblastic invasion of uterine spiral arteries leads to inadequate placental perfusion, which triggers systemic endothelial dysfunction, oxidative stress, and inflammatory responses. These changes increase maternal vascular resistance and contribute to the development of hypertension and related cardiovascular complications during pregnancy [15].

Although arrhythmias were observed in a smaller proportion of participants (6.27%), pregnancy is known to predispose women to rhythm disturbances due to physiological cardiovascular adaptations, including increased blood volume, elevated cardiac output, and hormonal influences on myocardial excitability. Most pregnancy-associated arrhythmias are benign; however, careful monitoring is necessary because persistent arrhythmias may compromise maternal hemodynamic stability and foetal oxygenation.

The very low occurrence of heart failure (0.66%) and the absence of peripartum cardiomyopathy and thromboembolic disorders in the present study may reflect the relatively young age distribution and generally favourable baseline health status of the study population. Nevertheless, these conditions remain clinically significant in obstetric practice due to their potential for severe maternal morbidity.

From a clinical pharmacy perspective, early identification and appropriate pharmacotherapeutic management of cardiovascular complications during pregnancy are essential to reduce maternal and foetal risks. Clinical pharmacists play an important role in optimizing antihypertensive therapy, evaluating drug safety profiles during pregnancy, monitoring potential drug-related adverse effects, and supporting multidisciplinary antenatal care. Evidence-based pharmacological interventions, combined with regular maternal monitoring, can significantly improve clinical outcomes in pregnant women with cardiovascular disorders.

Overall, the findings of this study emphasize the predominance of hypertensive disorders as the major cardiovascular complication during pregnancy, highlighting the importance of early screening, risk assessment, and multidisciplinary management strategies to prevent adverse maternal and foetal outcomes.

Table 2: Prevalence of cardiac complications among pregnant women included in the study population (N = 303).

Hypertensive Disorders in Pregnancy

The incidence and distribution of hypertensive disorders identified among the study participants are presented in Table 3. The analysis demonstrated that gestational hypertension was the most frequently observed condition (125 cases), followed by preeclampsia (58 cases) and eclampsia (8 cases). This distribution indicates that mild to moderate hypertensive conditions occurred more commonly than severe complications within the study population. The predominance of gestational hypertension is consistent with epidemiological patterns reported in obstetric surveillance studies, where gestational hypertension typically represents the earliest and most prevalent manifestation of hypertensive disorders during pregnancy [16].

The variation in blood pressure levels among the different hypertensive disorders is illustrated in Figure 2. The graphical representation demonstrates a progressive increase in both systolic and diastolic blood pressure values across the clinical spectrum, beginning with gestational hypertension and advancing toward preeclampsia and eclampsia. Women diagnosed with eclampsia exhibited the highest blood pressure measurements, reflecting severe vascular dysfunction and advanced disease progression. These findings align with established clinical observations that hypertensive disorders represent a continuum of disease severity characterized by increasing hemodynamic instability and systemic endothelial injury [16].

Comparative analysis of blood pressure measurements across the hypertensive categories revealed a gradual escalation in mean systolic and diastolic blood pressure from gestational hypertension to eclampsia, suggesting progressive cardiovascular strain associated with worsening disease severity. The observed differences between the hypertensive disorder categories were statistically significant (p < 0.05), indicating that blood pressure levels increased systematically with the severity of the condition. Elevated blood pressure during pregnancy is primarily driven by abnormal placental implantation and impaired remodelling of uterine spiral arteries, which results in placental hypoperfusion, oxidative stress, and systemic endothelial dysfunction. These pathophysiological mechanisms ultimately contribute to increased vascular resistance and widespread maternal organ involvement.

Hypertensive disorders of pregnancy represent a major global health concern and remain among the leading causes of maternal morbidity and mortality worldwide. Clinical evidence suggests that uncontrolled hypertension during pregnancy may lead to severe maternal complications, including placental abruption, renal impairment, hepatic dysfunction, cerebrovascular accidents, and progression to eclampsia. In addition to maternal complications, hypertensive disorders also significantly affect foetal outcomes by impairing uteroplacental circulation, which may result in intrauterine growth restriction, preterm birth, and perinatal mortality [16].

From a clinical pharmacotherapy perspective, the early identification and appropriate management of hypertensive disorders during pregnancy are essential to prevent disease progression and reduce adverse outcomes. Pharmacological management often involves the careful use of antihypertensive agents such as labetalol, nifedipine, and methyldopa, which are considered relatively safe during pregnancy when used under appropriate clinical supervision. Clinical pharmacists play an important role in optimizing antihypertensive therapy, monitoring drug safety, preventing medication-related complications, and ensuring adherence to evidence-based treatment guidelines.

Overall, the findings of the present study highlight the predominance of gestational hypertension and demonstrate a clear progression of blood pressure severity across hypertensive disorders of pregnancy. These results emphasize the importance of routine antenatal blood pressure monitoring, early risk stratification, and multidisciplinary management to minimize maternal and foetal complications associated with hypertensive pregnancy disorders.

Table 3. Incidence of Different Hypertensive Disorders

Figure 1. Blood Pressure Trends in Hypertensive Pregnancy Disorders

(Bar graph illustrating progressive elevation in systolic and diastolic blood pressure from gestational hypertension to preeclampsia and eclampsia.)

Maternal and Neonatal Outcomes in Hypertensive Pregnancies

The maternal and neonatal outcomes associated with hypertensive disorders of pregnancy are summarized in Table 4. The analysis revealed that preterm birth occurred considerably more frequently among hypertensive pregnancies (21.5%) compared with non-hypertensive pregnancies (5.4%). This finding indicates a strong association between maternal hypertension and premature delivery. In contrast, the occurrence of foetal growth restriction showed relatively similar proportions between hypertensive (5.2%) and non-hypertensive pregnancies (5.4%), suggesting that additional maternal or placental factors may influence foetal growth patterns in this cohort. The incidence of stillbirth was slightly lower among hypertensive pregnancies (6.3%) compared with non-hypertensive pregnancies (10.7%), whereas maternal stroke was reported in a small proportion of both groups, reflecting the relatively low frequency of severe neurological complications within the study population.

The comparative distribution of these maternal and neonatal outcomes is illustrated in Figure 3, which demonstrates the higher frequency of preterm birth among pregnancies complicated by hypertension.

Statistical comparison of maternal and neonatal outcomes revealed that preterm birth was significantly more common among hypertensive pregnancies (p < 0.05). Hypertensive disorders of pregnancy are characterized by impaired uteroplacental perfusion resulting from endothelial dysfunction and increased vascular resistance, which compromises oxygen and nutrient delivery to the foetus. As a result, clinicians may need to initiate early delivery to prevent maternal and foetal deterioration, thereby increasing the incidence of preterm birth. Although other outcomes such as foetal growth restriction and stroke did not demonstrate strong statistical differences between the groups in this study, hypertensive disorders remain important contributors to adverse obstetric outcomes.

Hypertensive disorders of pregnancy are widely recognized as one of the major causes of maternal and neonatal morbidity worldwide. The increased prevalence of preterm birth observed in this study is consistent with previous research indicating that hypertension during pregnancy often leads to placental insufficiency and foetal compromise, necessitating medically indicated preterm delivery. Large cohort studies have reported that women with hypertensive disorders are at significantly higher risk of delivering prematurely compared with normotensive pregnancies [17].

The pathophysiological mechanisms underlying these complications involve abnormal placental implantation and defective remodelling of uterine spiral arteries, which results in reduced placental perfusion and increased oxidative stress. These alterations contribute to placental ischemia and inflammatory responses, ultimately affecting foetal growth and increasing the likelihood of preterm birth and other neonatal complications [16].

Although foetal growth restriction was not markedly elevated in this study, previous investigations have shown that chronic uteroplacental insufficiency associated with hypertensive disorders may impair foetal nutrient supply, thereby increasing the risk of intrauterine growth restriction and low birth weight [18]. Furthermore, severe hypertensive complications such as eclampsia may predispose pregnant women to rare but life-threatening events including cerebrovascular accidents and organ dysfunction.

From a clinical pharmacy perspective, effective management of hypertensive disorders during pregnancy requires careful selection and monitoring of antihypertensive therapy to balance maternal cardiovascular stability with foetal safety. Medications such as labetalol, nifedipine, and methyldopa are commonly recommended as first-line agents due to their favorable safety profiles in pregnancy. Clinical pharmacists play an important role in monitoring therapeutic response, preventing drug-related adverse effects, and supporting multidisciplinary care strategies aimed at improving maternal and neonatal outcomes.

Overall, the findings of the present study highlight the significant association between hypertensive disorders and adverse obstetric outcomes, particularly preterm birth. These results emphasize the importance of early antenatal screening, regular blood pressure monitoring, and evidence-based pharmacological management to reduce the burden of hypertensive complications during pregnancy.

Table 4. Maternal and Neonatal Outcomes in Hypertensive Disorders

Figure 3. Comparison of Maternal and Neonatal Outcomes in Hypertensive and Non-Hypertensive Pregnancies

(Bar chart comparing the frequency of maternal and neonatal outcomes between hypertensive and normotensive pregnancies.)

Endocrine Complications in Pregnancy

The prevalence of endocrine disorders observed among the study participants is summarized in Table 5. Among the endocrine abnormalities identified, thyroid disorders were the most frequently reported condition, affecting 127 women (41.9%), followed by gestational diabetes mellitus (98 cases; 32.3%), while adrenal dysfunction was rare, with only 2 cases (0.7%) reported during the study period. These findings indicate that thyroid-related abnormalities represent the predominant endocrine complication affecting pregnant women in the present cohort.

The distribution of endocrine disorders is illustrated in Figure 4, which demonstrates the relative proportion of thyroid dysfunction, gestational diabetes mellitus, and adrenal disorders within the study population. The graphical representation clearly highlights thyroid disorders as the leading endocrine disturbance observed during pregnancy.

Descriptive statistical analysis revealed that thyroid disorders accounted for the largest proportion of endocrine complications in the study population. The prevalence of thyroid dysfunction was substantially higher than that of gestational diabetes mellitus and adrenal disorders. Although adrenal dysfunction occurred infrequently, its presence remains clinically important due to its potential impact on maternal hemodynamic stability and foetal development.

Endocrine disorders during pregnancy represent an important clinical concern because hormonal imbalances can significantly influence both maternal physiology and foetal development. In the present study, thyroid disorders were identified as the most prevalent endocrine complication, accounting for nearly two-fifths of the study population. Thyroid hormones are essential for regulating maternal metabolism, maintaining normal placental function, and supporting foetal brain development, particularly during early gestation when the foetus relies entirely on maternal thyroid hormone supply.

Abnormalities in thyroid function during pregnancy, including hypothyroidism, hyperthyroidism, and subclinical thyroid disorders, have been associated with several adverse obstetric outcomes such as miscarriage, preterm birth, gestational hypertension, and impaired neurocognitive development in offspring. These complications occur primarily due to alterations in maternal metabolic regulation and placental hormone interactions that influence foetal growth and development.

The relatively high prevalence of gestational diabetes mellitus (32.3%) observed in this study further highlights the metabolic challenges associated with pregnancy. Gestational diabetes results from pregnancy-induced insulin resistance combined with inadequate pancreatic β-cell compensation, leading to maternal hyperglycaemia. Uncontrolled maternal glucose levels can contribute to complications such as macrosomia, neonatal hypoglycaemia, and increased risk of future type 2 diabetes in both mother and child.

The very low occurrence of adrenal dysfunction (0.7%) in this cohort is consistent with clinical observations that adrenal disorders during pregnancy are relatively rare compared with thyroid and glucose metabolism abnormalities. However, conditions such as Cushing’s syndrome or adrenal insufficiency, although uncommon, can significantly affect maternal cardiovascular stability and pregnancy outcomes if not diagnosed and managed appropriately.

These findings are consistent with international epidemiological studies indicating that thyroid dysfunction is one of the most prevalent endocrine disorders affecting pregnant women globally. Global health reports have emphasized the importance of routine screening for thyroid abnormalities during pregnancy, particularly in regions where iodine deficiency or autoimmune thyroid disease is common [18].

From a clinical pharmacy and pharmacotherapeutic perspective, early detection and appropriate management of endocrine disorders are critical for optimizing maternal and foetal outcomes. Clinical pharmacists play a key role in monitoring pharmacotherapy for thyroid disorders and gestational diabetes, evaluating drug safety during pregnancy, adjusting medication dosages when necessary, and educating patients about adherence and lifestyle modifications. Integrating pharmaceutical care into antenatal services can enhance medication safety and improve therapeutic outcomes for pregnant women experiencing endocrine complications.

Overall, the findings of the present study emphasize the predominance of thyroid disorders and gestational diabetes among endocrine complications during pregnancy. These results underscore the importance of routine antenatal endocrine screening, multidisciplinary management strategies, and evidence-based pharmacotherapy to reduce maternal and neonatal risks associated with endocrine abnormalities.

Table 5. Prevalence of Endocrine Disorders in Pregnancy

Figure 4. Distribution of Endocrine Disorders in Pregnancy

(Pie chart illustrating the proportion of thyroid disorders, gestational diabetes mellitus, and adrenal dysfunction among pregnant women.)