IDF21-0190 Maternal and perinatal outcomes during the COVID-19 epidemic in pregnancies complicated by gestational diabetes

Abstract

Background: The COVID-19 epidemic is having a profound impact on healthcare delivery, including gestational diabetes (GDM). Aim: We aimed to evaluate effects of an epidemic on pregnancy outcomes in GDM. Method: Compared were outcomes of women, visiting university hospital diabetes clinic from March 12th 2020 until December 31st 2020 with those from the same period in 2019. Differences in maternal outcomes (insulin treatment, gestational weight gain, caesarean section, hypertensive disorders) and perinatal outcomes (rates of large and small for gestational age, preterm birth and a composite outcome including hyperbilirubinemia, hypoglycaemia, birth trauma, stillbirth, neonatal death) were calculated by a logistic regression model. Results: Our dataset included 1626 women. More women, diagnosed with GDM during the COVID-19 epidemic (n=768), were diagnosed in the 1st trimester (42.7% vs. 21.1%), had higher fasting glucose (5.2 [5.1–5.4] vs. 5.1 [4.8–5.3] mmol/l), earlier pharmacological therapy initiation and lower HbA1c (4.9% (30 mmol/mol) [4.8% (29 mmol/mol)–5.1% (32 mmol/mol)] vs. 5.0% (31 mmol/mol) [4.8 % (29 mmol/mol) –5%·(31 mmol/mol)], p<0.001) compared to a year before (n=566). Also, there was a lower risk for a composite perinatal outcome (adjusted odds ratio 0.66 [0.44–0.98], p <0.05). Discussion: COVID-19 epidemic facilitated better glucose management leading to improved perinatal outcomes. Our data highlights the importance of early screening of GDM for timely hyperglycaemia treatment and calls for a re-evaluation of GDM screening approaches during second and third wave of COVID-19 epidemic, as well as re-evaluation of the positioning of early GDM screening in general.