Gestational diabetes cases increased during the COVID-19 pandemic

More pregnant women developed gestational diabetes during the COVID-19 pandemic than in the preceding two years, according to research being presented on Thursday at ENDO 2023, the Endocrine Society's annual meeting in Chicago, Ill.

"Gestational diabetes appears to have become more common during the COVID-19 pandemic due to both changes in the population and changes related to the pandemic, which has significant short-term and long-term impact for mothers and their children worldwide," said study author Yoon Ji Jina Rhou, M.B.B.S., M.P.H., of the Reproduction and Perinatal Centre, University of Sydney in Sydney, Australia.

Rhou and colleagues completed a retrospective, multi-center cohort study of pregnancies at three hospitals over the course of two years pre-COVID-19 (January 2018-January 2020), the first year of the COVID-19 pandemic with a low COVID-19 pandemic burden and limited restrictions (February 2020-January 2021), and the second year of COVID-19 with increased burden and restrictions (February 2021-January 2022).

They looked at the birth mother's characteristics, gestational weight gain and pregnancy outcomes between the three time periods. Rhou and colleagues aimed to explore the number of cases of gestational diabetes and the factors underlying the change.

They identified 28,207 pregnancies, of which 14,663 took place in the two years preceding COVID-19, 6,890 happened in the first year, and 6,654 in the second year. It is important to note that the study population included 82.5% non-Caucasians and 22.7% who were at the greatest socioeconomic disadvantage.

The researchers discovered statistically significant increases in pre-pregnancy body-mass index, obesity, and other risk factors for gestational diabetes, including those with South Asian ethnicity and a previous history of gestational diabetes. The weekly rate of gestational weight gain increased during the pandemic periods and exceeded recommendations.

The analysis showed a progressive increase in the risk of gestational diabetes in the first and second-year pandemic periods. The incidence rose from 21% pre-pandemic to 25% in the second year, with the second year remaining significantly associated after adjusting for the birth mother's baseline characteristics and gestational weight gain. Change in baseline risk factors contributed to the rising number of gestational diabetes cases. These were not the only cause in the second year with increased restrictions, suggesting potential effects of factors such as lifestyle changes related to the pandemic.

"This study highlights unrecognized implications of pandemics and pandemic-related measures on pregnancy outcomes and the need for initiatives to limit this impact in current and future pandemics," Rhou said.