Effects of the Covid-19 Pandemic on Gestational Diabetes in Castilla La Mancha (Spain)

Abstract Aim: To assess the effect of the coronavirus disease 2019 (COVID-19) pandemic on gestational diabetes mellitus (GDM). Methods: In this observational, multicentre, retrospective study conducted in Castilla La Mancha, Spain, we compared 663 women with GDM exposed to pandemic (pandemic group) with 622 women with GDM who were attended 1 year before (prepandemic group). The primary outcome was large for gestational age (LGA) newborns as an indicator of GDM poor control. Secondary outcomes included maternal and neonatal morbidity. Results: During the pandemic the gestational week at diagnosis (24.2 ± 7.4 vs 22.9 ± 7.7, p = 0.0016) and at the first visit to Endocrinology (26.6 ± 7.2 vs 25.3 ± 7.6, p = 0.0014) were earlier. Face-to-face visits were maintained to a large extent (80.3%). The new diagnostic criteria of GDM was only used in the 3% of cases. However, in the pandemic group the final HbA1c was higher (+ 0.09%, p = 0.047) and there were more LGA newborns (8.5% vs 12.8%, p = 0.015). There were no differences in perinatal complications. Conclusion: Medical care for GDM in our Public Health System did not suffer a significant deterioration during the pandemic. However, this did not prevent a greater number of LGA newborns. The use of temporary alternatives for the diagnosis of GDM during the Covid-19 pandemic was associated with having a LGA newborn. These diagnostic criteria should be reconsidered or maybe in future pandemics we should maintain the usual diagnostic protocol.