Gestational Diabetes Mellitus Prevalence and the COVID-19 Pandemic:
Characterizing Medical and Socioeconomic Risk Factors
Abstract
Objective: Emerging evidence suggests a possible link between
the COVID-19 pandemic and a rise in GDM prevalence, however, this
relationship is not well characterized. This study assesses
socioeconomic and medical risk factors associated with GDM across phases
of the COVID-19 pandemic. Design: A retrospective cohort of all
maternal deliveries from October 2015 - May 2022 was stratified between
Pre-Pandemic, Lockdown, and Post Lockdown phases. Maternal demographics,
gestational characteristics, and medical pregnancy complications were
assessed. Setting: Sutter Sacramento Medical Center, a large
community hospital in Sacramento, CA. Population: All maternal
deliveries from October 2015 through May 2022 were included.
Methods: Contingency tables, Χ 2 tests of
independence, and logistic regression models were applied for data
analysis. Main Outcome Measures: A total of 41,246 deliveries
were evaluated. GDM prevalence was 5.4% overall (4.1% Pre-Pandemic,
7.6% Lockdown, 7.1% Post Lockdown). Results: Adjusted odds of
GDM were 1.62 in Lockdown (95% CI:1.41-1.85) and 1.462 in Post Lockdown
(95% CI:1.307-1.635). Variables associated with GDM included maternal
age ≥35 years, Hispanic ethnicity, Asian or “Other” race, obesity,
multiple gestation, PCOS, and preeclampsia. Risk factors for GDM were
similar across the three periods. Conclusions: The surge in GDM
prevalence observed during the Lockdown and Post Lockdown periods was
not fully explained by identified socioeconomic and medical risk
factors. COVID-19 pandemic-specific factors may underlie these trends.