Impact of COVID-19 on gestational diabetes pregnancy outcomes in the UK: A multicentre retrospective cohort study

Mclennan, Niamh-Maire, Lindsay, Robert, Saravanan, Ponnusamy, Sukumar, Nithya, White, Sara L., von Dadelszen, Peter, Burden, Christy, Hunt, Kathryn, George, Priya, Hirst, Jane E., Lattey, Katherine, Lee, Tara T. M. ORCID:, Murphy, Helen R., Scott, Eleanor M., Magee, Laura A. and Reynolds, Rebecca M. and the Diabetes in Pregnancy Working Group (2024) Impact of COVID-19 on gestational diabetes pregnancy outcomes in the UK: A multicentre retrospective cohort study. BJOG: An International Journal of Obstetrics and Gynaecology, 131 (6). pp. 858-868. ISSN 1470-0328

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Objective: To determine the impact of implementing emergency care pathway(s) for screening, diagnosing and managing women with gestational diabetes (GDM) during COVID-19.   Design: Retrospective multicentre cohort.   Setting: Nine National Health Service (NHS) Hospital Trusts/Health boards in England and Scotland.   Population: 4915 women with GDM pre-pandemic (1 April 2018 to 31 March 2020), and 3467 women with GDM during the pandemic (1 May 2020 to 31 March 2021).   Methods: We examined clinical outcomes for women with GDM prior to and during the pandemic following changes in screening methods, diagnostic testing, glucose thresholds and introduction of virtual care for monitoring of antenatal glycaemia.   Main Outcome Measures: Intervention at birth, perinatal mortality, large-for-gestational-age infants and neonatal unit admission.   Results: The new diagnostic criteria more often identified GDM women who were multiparous, had higher body mass index (BMI) and greater deprivation, and less frequently had previous GDM (all p < 0.05). During COVID, these women had no differences in the key outcome measures. Of the women, 3% were identified with pre-existing diabetes at antenatal booking. Where OGTT continued during COVID, but virtual care was introduced, outcomes were also similar pre- and during the pandemic.   Conclusions: Using HbA1c and fasting glucose identified a higher risk GDM population during the pandemic but this had minimal impact on pregnancy outcomes. The high prevalence of undiagnosed pre-existing diabetes suggests that women with GDM risk factors should be offered HbA1c screening in early pregnancy.

Item Type: Article
Additional Information: Funding information: British Heart Foundation. Grant Number: RE/18/5/34216; Diabetes Research & Wellness Foundation Sutherland-Earl Clinical Fellowship
Uncontrolled Keywords: covid-19,gestational diabetes,obstetrics and gynaecology,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2729
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
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Depositing User: LivePure Connector
Date Deposited: 10 May 2024 16:30
Last Modified: 20 May 2024 08:30
DOI: 10.1111/1471-0528.17716


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