Postprandial hyperglycaemia screening and pregnancy outcomes-lessons
from COVID-19: a data linkage study.
Objective To describe the maternal and neonatal outcomes of pregnant
women with fasting blood glucose <4.7 mmol/L for whom the
diagnosis and treatment pathways differed due to COVID-19. Design,
setting and population. An Australian population-based data linkage
study involving 3891 women. Methods: Pregnant women with fasting blood
glucose <4.7 mmol/L between 24-32 weeks of gestation were
categorized into three groups: women diagnosed with gestational diabetes
by postprandial hyperglycaemia (PPGDM; n= 226); normal glucose tolerance
group (NGT; n= 3125) and women not tested for postprandial
hyperglycaemia, mostly during COVID-19 (LFBG; n= 540). The maternal and
neonatal outcomes between groups were compared using generalized linear
models. Main outcome measures: Risk of Large for gestational age baby.
Results: Mean difference in birth weight (-115 grams, 95%CI -175.5—
-32.6) and z-scores (-0.11, 95%CI -0.26— 0.02) were lower in the
PPGDM group compared to the LFBG group. However, there were no
differences between PPGDM and LFBG groups in the risk of large for
gestational age (LGA) infants (RR: 1.09, 95%CI 0.66— 1.78). The
maternal and neonatal outcomes in the LFBG group were comparable to the
NGT group. Conclusion: The risk of LGA was similar across all groups
regardless of post prandial glycemia and its treatment. Overall, women
with a fasting blood glucose <4.7 mmol/L can be considered as
a low-risk group for adverse perinatal outcomes.