Objective: to investigate a possible bi-directional association between gestational diabetes (GDM) and the SARS-CoV-2 infection during pregnancy. Design: case-control study with prospective data collection for the case group and 1:2 matching with historical controls Setting: University Hospital of Bern, Switzerland Population: 224 pregnant women: 75 cases with SARS-CoV-2 infection during pregnancy, matched 1:2 with controls based on parity, BMI and ethnicity. Methods: SARS-CoV-2 infection was diagnosed by RT-PCR. Screening for GDM was performed by 75mg oral glucose tolerance test at 26 weeks’ gestation in all women. Main Outcomes: Prevalence of GDM was calculated in both groups. Multivariate binary logistic regression analysis was performed to assess risk factors for GDM and inpatient COVID-19 management. Results: 34.6% of the patients in the case group suffered from GDM, vs. 16.1% in the control group (p=0.002). 35.7% patients were diagnosed with GDM after the SARS-CoV-2 infection, vs. 33.3% diagnosed before infection (OR(95%CI) 1.11(0.40-3.08), p=0.84), with no correlation between the time-point of infection and GDM diagnosis. SARS-CoV-2 (OR(95%CI) 2.79 (1.42, 5.47), p=0.003) and BMI (OR(95%CI) 1.12 (1.05, 1.19), p=0.001) were significant independent risk factors for GDM. Conclusions: The significantly higher rate of GDM among women with SARS-CoV-2 infection during pregnancy, as compared to matching controls, suggests that GDM increases the risk of infection. On the other hand, SARS-CoV-2 during pregnancy might increase the risk of developing GDM. Vaccination and caution in using protective measures should be recommended to pregnant women, particularly those with co-morbidities. Funding: none Keywords: SARS-CoV-2, gestational diabetes, COVID-19

Objective Acute fatty liver of pregnancy (AFLP) substantially contributes to maternal and neonatal morbidity and mortality. The aim of this study was to investigate angiogenic profiles by measuring soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PLGF) in pregnancies compromised by AFLP and to compare them to those complicated by HELLP (haemolysis, elevated liver enzyme, low platelet) syndrome. Methods In pregnant patients affected by AFLP or HELLP syndrome sFlt-1 and PLGF serum levels were measured. To assess the diagnostic potential of these angiogenic markers in AFLP as well as discriminating it from HELLP syndrome, non-parametric tests were used and receiver-operating-curves (ROC) were calculated. Results Six cases with AFLP and 48 women with HELLP syndrome were included into the study. Patients with AFLP showed significantly higher sFlt-1 levels (median: 57570pg/ml [range: 31609-147170pg/ml]) than patients with HELLP syndrome (9713pg/ml [1348-30781pg/ml ; p<0.001). PLGF serum levels were increased in patients with AFLP compared to those with HELLP syndrome (197 pg/ml [127-487pg/ml] versus 40 pg/ml [9-644pg/ml], respectively, p<0.01,). sFlt-1/PLGF-ratios were not significantly different between AFLP and HELLP syndrome patients (192 [157-1159] versus 232 [3-948], respectively, NS). A sFlt-1 cut-off value of 31100pg/ml allowed differentiating between these two diseases with a sensitivity and specificity of 100%. Conclusions AFLP is associated with very high serum levels of sFlt-1. Besides the suggested Swansea criteria to diagnose AFLP a sFlt-1 value above 31100 pg/ml may be also an additional biochemical feature improving discrimination between AFLP and HELLP syndrome. Funding:NA Keywords:AFLP, HELLP syndrome, preeclampsia, sFLT-1, PLGF