tetano
Editor, Senior Moderator
BMJ Open Diabetes Res Care
. 2024 Jan 25;12(1):e003724.
doi: 10.1136/bmjdrc-2023-003724. Adverse perinatal outcomes in gestational diabetes mellitus with and without SARS-CoV-2 infection during pregnancy: results from two nationwide registries in Germany
Tatjana P Liedtke[SUP] 1 [/SUP], Katharina S Weber[SUP] 1 [/SUP], Heinke Adamczewski[SUP] 2 [/SUP], Dietmar Weber[SUP] 2 [/SUP], Babett Ramsauer[SUP] 3 [/SUP], Ute M Schaefer-Graf[SUP] 4 [/SUP], Tanja Groten[SUP] 5 [/SUP], Eike A Strathmann[SUP] 1 [/SUP], Wolfgang Lieb[SUP] 1 [/SUP], Mario Rüdiger[SUP] 6 [/SUP], Ulrich Pecks[SUP] 7 8 [/SUP], Helmut J Kleinwechter; CRONOS-GestDiab Collaboration
Affiliations
Introduction: Pregnancy is a known independent risk factor for a severe course of COVID-19. The relationship of SARS-CoV-2 infection and gestational diabetes mellitus (GDM) on neonatal outcomes is unclear. Our aim was to determine if SARS-CoV-2 infection represents an independent risk factor for adverse perinatal outcomes in pregnancy with GDM.
Research design and methods: We compared data from two German registries including pregnant women with GDM, established during the SARS-CoV-2 pandemic (COVID-19-Related Obstetric and Neonatal Outcome Study (CRONOS), a multicenter prospective observational study) and already existing before the pandemic (German registry of pregnant women with GDM; GestDiab). In total, 409 participants with GDM and SARS-CoV-2 infection and 4598 participants with GDM, registered 2018-2019, were eligible for analyses. The primary fetal and neonatal outcomes were defined as: (1) combined: admission to neonatal intensive care unit, stillbirth, and/or neonatal death, and (2) preterm birth before 37+0 weeks of gestation. Large and small for gestational age, maternal insulin therapy, birth weight >4500 g and cesarean delivery were considered as secondary outcomes.
Results: Women with SARS-CoV-2 infection were younger (32 vs 33 years) and had a higher median body mass index (28 vs 27 kg/m²). In CRONOS, more neonates developed the primary outcome (adjusted OR (aOR) 1.48, 95% CI 1.11 to 1.97) and were born preterm (aOR 1.50, 95% CI 1.07 to 2.10). Fasting glucose was higher in women in CRONOS versus GestDiab (5.4 vs 5.3 mmol/L) considering each 0.1 mmol/L increase was independently associated with a 5% higher risk of preterm birth among women in CRONOS only (aOR 1.05, 95% CI 1.01 to 1.09).
Conclusions: GDM with SARS-CoV-2 infection in pregnancy is associated with an increased risk of adverse fetal and neonatal outcomes as compared with GDM without SARS-CoV-2 infection.
Keywords: COVID-19; Diabetes, Gestational; Pregnancy Outcome.
. 2024 Jan 25;12(1):e003724.
doi: 10.1136/bmjdrc-2023-003724. Adverse perinatal outcomes in gestational diabetes mellitus with and without SARS-CoV-2 infection during pregnancy: results from two nationwide registries in Germany
Tatjana P Liedtke[SUP] 1 [/SUP], Katharina S Weber[SUP] 1 [/SUP], Heinke Adamczewski[SUP] 2 [/SUP], Dietmar Weber[SUP] 2 [/SUP], Babett Ramsauer[SUP] 3 [/SUP], Ute M Schaefer-Graf[SUP] 4 [/SUP], Tanja Groten[SUP] 5 [/SUP], Eike A Strathmann[SUP] 1 [/SUP], Wolfgang Lieb[SUP] 1 [/SUP], Mario Rüdiger[SUP] 6 [/SUP], Ulrich Pecks[SUP] 7 8 [/SUP], Helmut J Kleinwechter; CRONOS-GestDiab Collaboration
Affiliations
- PMID: 38272538
- DOI: 10.1136/bmjdrc-2023-003724
Introduction: Pregnancy is a known independent risk factor for a severe course of COVID-19. The relationship of SARS-CoV-2 infection and gestational diabetes mellitus (GDM) on neonatal outcomes is unclear. Our aim was to determine if SARS-CoV-2 infection represents an independent risk factor for adverse perinatal outcomes in pregnancy with GDM.
Research design and methods: We compared data from two German registries including pregnant women with GDM, established during the SARS-CoV-2 pandemic (COVID-19-Related Obstetric and Neonatal Outcome Study (CRONOS), a multicenter prospective observational study) and already existing before the pandemic (German registry of pregnant women with GDM; GestDiab). In total, 409 participants with GDM and SARS-CoV-2 infection and 4598 participants with GDM, registered 2018-2019, were eligible for analyses. The primary fetal and neonatal outcomes were defined as: (1) combined: admission to neonatal intensive care unit, stillbirth, and/or neonatal death, and (2) preterm birth before 37+0 weeks of gestation. Large and small for gestational age, maternal insulin therapy, birth weight >4500 g and cesarean delivery were considered as secondary outcomes.
Results: Women with SARS-CoV-2 infection were younger (32 vs 33 years) and had a higher median body mass index (28 vs 27 kg/m²). In CRONOS, more neonates developed the primary outcome (adjusted OR (aOR) 1.48, 95% CI 1.11 to 1.97) and were born preterm (aOR 1.50, 95% CI 1.07 to 2.10). Fasting glucose was higher in women in CRONOS versus GestDiab (5.4 vs 5.3 mmol/L) considering each 0.1 mmol/L increase was independently associated with a 5% higher risk of preterm birth among women in CRONOS only (aOR 1.05, 95% CI 1.01 to 1.09).
Conclusions: GDM with SARS-CoV-2 infection in pregnancy is associated with an increased risk of adverse fetal and neonatal outcomes as compared with GDM without SARS-CoV-2 infection.
Keywords: COVID-19; Diabetes, Gestational; Pregnancy Outcome.