Gestational diabetes increase associated with covid-19 pandemic in an inner-city multi-ethnic cohort

ABSTRACT

Background and Aims: During the covid-19 pandemic revisions were recommended to the gestational diabetes diagnostic criteria. Given the characteristics of our inner city multi-ethnic cohort, we continued with the NICE 2015 criteria. We aimed to determine the incidence of gestational diabetes during the first wave of the covid-19 pandemic. Methods: Women diagnosed with gestational diabetes in March-July 2020 were retrospectively reviewed and compared to two separate historical time-matched cohorts (03-07/ 2018 and 03-07/ 2017). Maternal demographics, gestational diabetes incidence and fetal outcomes were compared. Results: 953 pregnancies were registered in 2020, 963 in 2018 and 1162 in 2017. The highest gestational diabetes incidence was observed in the covid-19 cohort (12.6% (n = 120), 7.3% (n = 70) and 4.4% (n = 52) respectively, p < 0.001). On average, women were diagnosed with GDM later in 2020 (mean gestational age (GA) 28.6 weeks, 27.0 and 27.0 weeks, p < 0.001). Mean ( ± SD) age, height, and early pregnancy weight/ body mass index were similar. Proportional differences in women with gestational diabetes of non-white ethnicity were exhibited, with the lowest proportion in 2020 (77.0%, 86.4% and 82.9% respectively, p < 0.001). Mean ( ± SD) fetal birth weight varied across the groups (3237.5 ( ± 473)g, 3117 ( ± 647)g and 2981 ( ± 845)g, p < 0.001). There were no differences in adjusted fetal birth weight centiles. Mean (SD) GA at birth was higher in 2020 (38.8 ( ± 1.26), 38.4 ( ± 2.38), 37.60 ( ± 5.1) weeks, p = 0.03). Conclusions: A significant increase in the diagnosis of gestational diabetes during the covid-19 epidemic was observed. The implementation of national lockdowns may have resulted in reduced physical activity and excess gestational weight gain, which could explain this.