Vol 94, No 5 (2023)
Research paper
Published online: 2023-04-05

open access

Page views 2210
Article views/downloads 485
Get Citation

Connect on Social Media

Connect on Social Media

Comparison of the clinical characteristics, glycemic control, and pregnancy outcomes between women with gestational diabetes mellitus in waves I and III of the COVID-19 pandemic: a reference center report

Magdalena Wilk1, Magdalena Kwiatkowska1, Michal Kania1, Radoslaw Dziedzic2, Adam Stepien2, Katarzyna Cyganek1, Hubert Huras3, Maciej T. Malecki1
Pubmed: 37042324
Ginekol Pol 2023;94(5):389-394.

Abstract

Objectives: The medical care of patients with gestational diabetes mellitus (GDM) during the COVID-19 pandemic was influenced by changing epidemiological conditions and government regulations. Aim — To compare the clinical pregnancy data of GDM women between waves I and III of the pandemic. Material and methods: We performed a retrospective analysis of medical records from the GDM clinic and compared the periods of March–May 2020 (wave I) and March–May 2021 (wave III). Results: Women with GDM during wave I (n = 119) compared to wave III (n = 116) were older (33.0 ± 4.7 vs 32.1 ± 4.8 years; p = 0.07), booked later (21.8 ± 8.4 vs 20.3 ± 8.5 weeks; p = 0.17), and had their last appointment earlier (35.5 ± 2.0 vs 35.7 ± 3.2 weeks; p < 0.01). Telemedicine consultations were used more frequently during wave I (46.8% vs 24.1%; p < 0.01), while insulin therapy was used less often (64.7% vs 80.2%; p < 0.01). Mean fasting self-measured glucose did not differ (4.8 ± 0.3 vs 4.8 ± 0.3 mmol/L; p = 0.49), but higher postprandial glucose was reported during wave I (6.6 ± 0.9 vs 6.3 ± 0.6 mmol/l; p < 0.01). Pregnancy outcome data were available for 77 wave I pregnancies and 75 wave III pregnancies. The groups were similar in terms of gestational week of delivery (38.3 ± 1.4 vs 38.1 ± 1.6 weeks), cesarean sections (58.4% vs 61.3%), APGAR scores (9.7 ± 1.0 vs 9.7 ± 1.0 pts), and birth weights (3306.6 ± 457.6 g vs 3243.9 ± 496.8 g) (p = NS for all). The mean wave I neonate length was slightly higher (54.3 ± 2.6 cm vs 53.3 ± 2.6 cm; p = 0.04). Conclusions: We identified differences between wave I and wave III pregnancies for several clinical characteristics. However, nearly all pregnancy outcomes were found to be similar.

Article available in PDF format

View PDF Download PDF file

References

  1. Blumenthal D, Fowler EJ, Abrams M, et al. Covid-19 - Implications for the Health Care System. N Engl J Med. 2020; 383(15): 1483–1488.
  2. Murphy HR. Managing Diabetes in Pregnancy Before, During, and After COVID-19. Diabetes Technol Ther. 2020; 22(6): 454–461.
  3. Sweeting A, Wong J, Murphy HR, et al. A Clinical Update on Gestational Diabetes Mellitus. Endocr Rev. 2022; 43(5): 763–793.
  4. Chehab RF, Ferrara A, Greenberg MB, et al. Glycemic Control Trajectories and Risk of Perinatal Complications Among Individuals With Gestational Diabetes. JAMA Netw Open. 2022; 5(9): e2233955.
  5. Torlone E, Sculli MA, Bonomo M, et al. Recommendations and management of hyperglycaemia in pregnancy during COVID-19 pandemic in Italy. Diabetes Res Clin Pract. 2020; 166: 108345.
  6. Justman N, Shahak G, Gutzeit O, et al. Lockdown with a Price: The impact of the COVID-19 Pandemic on Prenatal Care and Perinatal Outcomes in a Tertiary Care Center. Isr Med Assoc J. 2020; 22(9): 533–537.
  7. Kleinwechter HJ, Weber KS, Mingers N, et al. COVID-19-Related Obstetric and Neonatal Outcome Study (CRONOS) Network. Gestational diabetes mellitus and COVID-19: results from the COVID-19-Related Obstetric and Neonatal Outcome Study (CRONOS). Am J Obstet Gynecol. 2022; 227(4): 631.e1–631.e19.
  8. Bociąga-Jasik M, Wojciechowska W, Terlecki M, et al. Comparison between COVID‑19 outcomes in the first 3 waves of the pandemic: a reference hospital report. Pol Arch Intern Med. 2022; 132(10).
  9. Wilk M, Surowiec P, Matejko B, et al. Diabetes Management Delivery and Pregnancy Outcomes in Women with Gestational Diabetes Mellitus during the First Wave of the 2020 COVID-19 Pandemic: A Single-Reference Center Report. J Diabetes Res. 2021; 2021: 5515902.
  10. Guidelines on the management of patients with Diabetes. A position of Diabetes Poland. Curr Top Diabetes. 2022; 2(1): 1–134.
  11. Virtanen P, Gommers R, Travis E, et al. Fundamental Algorithms for Scientific Computing in Python. Nature Methods. 2020; 17(3): 261–272.
  12. Sagan A, Bryndova L, Kowalska-Bobko I, et al. A reversal of fortune: Comparison of health system responses to COVID-19 in the Visegrad group during the early phases of the pandemic. Health Policy. 2022; 126(5): 446–455.
  13. Pinkas J, Jankowski M, Szumowski Ł, et al. Public Health Interventions to Mitigate Early Spread of SARS-CoV-2 in Poland. Med Sci Monit. 2020; 26: e924730.
  14. Eleftheriades M, Chatzakis C, Papachatzopoulou E, et al. Prediction of insulin treatment in women with gestational diabetes mellitus. Nutr Diabetes. 2021; 11(1): 30.
  15. Wong VW, Jalaludin B. Gestational diabetes mellitus: who requires insulin therapy? Aust N Z J Obstet Gynaecol. 2011; 51(5): 432–436.
  16. Bertini A, Gárate B, Pardo F, et al. Impact of Remote Monitoring Technologies for Assisting Patients With Gestational Diabetes Mellitus: A Systematic Review. Front Bioeng Biotechnol. 2022; 10.
  17. Eberle C, Stichling S. Telemedical Approaches to Managing Gestational Diabetes Mellitus During COVID-19: Systematic Review. JMIR Pediatr Parent. 2021; 4(3): e28630.
  18. American Diabetes Association Professional Practice Committee. 15. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022; 45(Suppl 1): S232–S243.
  19. Byström M, Liu A, Quinton AE, et al. Gestational Diabetes Independently Increases Birth Length and Augments the Effects of Maternal BMI on Birth Weight: A Retrospective Cohort Study. Front Pediatr. 2014; 2: 112.
  20. Nachtergaele C, Vicaut E, Pinto S, et al. COVID-19 pandemic: Can fasting plasma glucose and HbA1c replace the oral glucose tolerance test to screen for hyperglycaemia in pregnancy? Diabetes Res Clin Pract. 2021; 172: 108640.
  21. Meek CL, Lindsay RS, Scott EM, et al. Approaches to screening for hyperglycaemia in pregnant women during and after the COVID-19 pandemic. Diabet Med. 2021; 38(1): e14380.