Objective
Various international studies have demonstrated the contribution of the COVID-19 pandemic to the increase in sedentary lifestyles, postprandial glucose measurements and insulin use in patients with gestational diabetes mellitus (GDM), yet few studies have compared the rates of GDM prior to and during the COVID-19 pandemic. This study aimed to compare the rate of GDM and secondary maternal, infant and delivery outcomes, prior to, and during initial COVID-19 pandemic precautions.

Study Design
This single-center retrospective cohort study queried inpatient and outpatient medical record databases for adult pregnant women with a singleton pregnancy diagnosed with GDM, who delivered at St. Joseph Mercy Hospital-Ann Arbor between June 1st, 2019- December 31st, 2019 and June 1st, 2020- December 31st, 2020. Exclusion criteria included COVID diagnosis during pregnancy, pre-existing diabetes, incarceration, multiple gestations and known fetal anomalies. Maternal and infant charts were abstracted for secondary maternal, neonatal and delivery outcomes. Parametric and non-parametric statistics were utilized, where indicated.

Results
A significant increase in the rate of GDM was noted comparing pre-pandemic and pandemic groups: 12.2% [282/2346 total deliveries] vs 14.7% [323/2193], P=0.03, with no significant differences in maternal demographics. While there were no differences in need for medical management of GDM, delivery outcomes, birthweight, or NICU admission, there was an increased rate of neonatal hypoglycemia diagnosed during the COVID period (23% vs 31.3%, P=0.02).

Conclusion
After the statewide implementation of COVID-19 pandemic precautions, the rate of GDM at our institution increased significantly. This may reflect changes in prenatal care, more sedentary lifestyles and changes in nutrition which may also have contributed to increased neonatal hypoglycemia, despite average birthweight. Ongoing research is needed to further elucidate the impact of pandemic care on overall pregnancy outcomes beyond those attributed to COVID-19 infection.





Sources - https://www.sciencedirect.com/science/article/pii/S0002937822017501