Gestational diabetes insipidus. A systematic review of case reports.

Objectives: To evaluate the clinical characteristics and etiopathogenic factors associated with gestational diabetes insipidus (GDI), analyzing maternal and perinatal outcomes.

Methods: A systematic review was performed in PubMed, Embase and Scopus of articles on GDI published from January 1, 1980 to April 3, 2024. The review included 55 case reports on GDI, with a total of 64 women. Data on age, parity, diagnosis, management, and maternal and perinatal morbidity and mortality were collected. Descriptive statistical analysis was performed with SPSS version 17.0, considering a p value <0.05 as significant. Study quality was assessed with the Joanna Briggs Institute critical appraisal checklist.

Results: Of the 64 women studied, 65.6 % were primiparous and the mean gestational age at diagnosis was 32.7 weeks. There was a high prevalence of twin gestations (21.9 %) and a significant percentage of cesarean deliveries (54 %). Preeclampsia, Acute fatty liver of pregnancy and HELLP syndrome were significantly more prevalent. The incidence of prematurity was 54.7 % and the perinatal mortality rate was 78.1 ‰. These complications showed statistical significance (p<0.05), indicating the severity of GDI and its impact on obstetric outcomes.

Conclusions: GDI represents a complex clinical challenge with important implications for maternal-fetal health. The understanding of its aetiology, linked to vasopressinase activity and its relationship with various obstetric pathologies, is crucial for the diagnosis and proper management of this condition.