<b>MANAGEMENT OF PREGNANCIES AND OUTCOMES WITH </b><b>CO-MORBIDITIES LIKE OBESITY, DIABETES, AND INFECTIONS. </b><b>A SYSTEMATIC REVIEW</b>

Objective: This systematic review aims to evaluate recent advancements in the management of pregnancies complicated by obesity, diabetes, and infections, and to assess their impact on maternal and perinatal outcomes. Methods: A systematic search of electronic databases, including PubMed, Scopus, and ResearchGate, was conducted for studies published in the last decade. Eligible studies included randomized controlled trials, cohort studies, systematic reviews, and clinical guidelines addressing management strategies and pregnancy outcomes associated with maternal obesity, diabetes, and infections. Data were synthesized narratively in accordance with PRISMA guidelines. Results: Evidence indicates that maternal obesity is strongly associated with gestational diabetes mellitus, hypertensive disorders, cesarean delivery, and fetal macrosomia. Optimized glycemic control through early screening, lifestyle modification, continuous glucose monitoring, and pharmacotherapy significantly reduces adverse outcomes in pregnancies complicated by diabetes. Maternal infections were consistently linked with preterm birth, low birth weight, and perinatal mortality, with early diagnosis and targeted antimicrobial therapy demonstrating improved outcomes. Integrated, multidisciplinary care models and emerging digital health interventions showed promise in improving adherence and clinical outcomes across high-risk populations. Conclusion: Recent advancements in the management of pregnancies complicated by obesity, diabetes, and infections have led to measurable improvements in maternal and perinatal outcomes. However, disparities in care delivery and limited integration of evidence-based strategies remain challenges. Strengthening standardized protocols, early risk stratification, and multidisciplinary approaches is essential to optimize outcomes in high-risk pregnancies.