Gestational diabetes mellitus in the COVID‐19 pandemic: A retrospective study from Hangzhou, China

Abstract

Aims Our study aimed to investigate changes in the prevalence of gestational diabetes mellitus (GDM) in the COVID‐19 pandemic and postpandemic era and the risk of adverse pregnancy outcomes in pregnant women diagnosed with GDM during the blockade period. Methods First, we investigated changes in the prevalence of GDM and the population undergoing oral glucose tolerance tests (OGTT) after the COVID‐19 pandemic. We then collected clinical information from pregnant women diagnosed with GDM to explore the risk of adverse pregnancy outcomes in pregnant women with GDM during the COVID‐19 pandemic. Results After the COVID‐19 pandemic, the proportion of pregnant women in the total number of outpatient OGTT tests decreased yearly. The ratio was 81.30%, 79.71%, and 75.48% from 2019 to 2021, respectively, with the highest proportion of pregnant women in February 2020 (92.03%). The prevalence of GDM was higher in March 2020 compared to the same period in 2019. However, from 2019 to 2021, the prevalence decreased year by year with 21.46%, 19.81%, and 18.48%, respectively. The risk of adverse pregnancy outcomes for pregnant women diagnosed with GDM during the most severe period of the COVID‐19 pandemic did not differ from before the COVID‐19 pandemic. Conclusions After the COVID‐19 pandemic, the prevalence of GDM increased during the most severe period of the epidemic, but the overall prevalence of GDM decreased year by year. In addition, the pandemic did not change the risk of adverse pregnancy outcomes in pregnant women with GDM.

COVID-19, Pregnancy, and Diabetes Mellitus

“…The possible increase in the prevalence of GDM during the pandemic may be due to several reasons, such as behavioral changes during lockdown, direct damage to pancreatic beta cells by the virus, or an infection-induced increase in insulin resistance. The following results can be derived from numerous studies on this question: ▪ GDM prevalence is increasing possibly associated with changes in screening procedures or lifestyle changes [57][58][59][60][61][62]; ▪ GDM prevalence does not change or is decreasing [63][64][65][66]; ▪ GDM is associated with a severe course of COVID-19 or insulin therapy [23,67]; ▪ Gestational weight gain (GWG) as a risk factor for GDM increases [68]. Taken together, from the existing literature there is some evidence that during the first two years of the pandemic and with low vaccination rate GDM prevalence increased locally, probably secondary to changes in lifestyle, such as less exercise, increasing BMI during lockdown, and GWG.…”