Adverse perinatal outcomes in gestational diabetes mellitus with and without SARS-CoV-2 infection during pregnancy: results from two nationwide registries in Germany

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Tatjana P. Liedtke - , Kiel University (Author)
  • Katharina S. Weber - , Kiel University (Author)
  • Heinke Adamczewski - , Scientific Institute of Diabetologists in Practice (Author)
  • Dietmar Weber - , Scientific Institute of Diabetologists in Practice (Author)
  • Babett Ramsauer - , Vivantes Klinikum Neukolln (Author)
  • Ute M. Schaefer-Graf - , St. Joseph Hospital Berlin Tempelhof (Author)
  • Tanja Groten - , Friedrich Schiller University Jena (Author)
  • Eike A. Strathmann - , Kiel University (Author)
  • Wolfgang Lieb - , Kiel University (Author)
  • Mario Rüdiger - , Department of Paediatrics, Center for feto/neonatal Health, University Hospital Carl Gustav Carus Dresden (Author)
  • Ulrich Pecks - , University Hospital Schleswig-Holstein Campus Kiel, University of Würzburg (Author)
  • Helmut J. Kleinwechter - , Diabetes Center and Diabetes Education Center (Author)

Abstract

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.

Details

Original languageEnglish
Article numbere003724
JournalBMJ Open Diabetes Research and Care
Volume12
Issue number1
Publication statusPublished - 25 Jan 2024
Peer-reviewedYes

External IDs

PubMed 38272538

Keywords

Sustainable Development Goals

Keywords

  • COVID-19, Diabetes, Gestational, Pregnancy Outcome, Pregnancy, SARS-CoV-2, COVID-19/complications, Humans, Diabetes, Gestational/epidemiology, Premature Birth/epidemiology, Female, Registries, Infant, Newborn