Pregnancy and perinatal outcomes in women with pre-gestational diabetes before and during the COVID-19 pandemic
Keywords:COVID-19, Pregnancy, high-risk, Pregnancy in diabetics, Pregnancy outcome
Objective: This study compared the compliance with scheduled antenatal visits as well as pregnancy and perinatal outcomes of pregnant women with pre-gestational diabetes before and during the COVID-19 pandemic.
Methods: Medical records of women with singleton pregnancies and pre-gestational type I or type II diabetes who attended antenatal care at Tuen Mun Hospital between 1 September 2017 and 31 March 2022 were retrieved. Modifiable and non-modifiable risk factors associated with adverse pregnancy outcomes were analysed, including glycated haemoglobin levels, body mass index, smoking status, attendance of antenatal follow-up, maternal age, parity, ethnicity, diabetes type, pre-pregnancy medical conditions, Caesarean section rate, hypertensive disorders complicating pregnancy, preterm birth (birth at <37 weeks of gestation), and large and small for gestational age.
Results: Of 152 women included in the analysis, 78 attended between 4 January 2020 and 31 March 2022 (the pandemic group) and 74 attended between 1 September 2017 and 3 January 2020 (the pre-pandemic group). The two groups were comparable in terms of compliance with their scheduled antenatal visits and all pregnancy and perinatal outcomes, except that the pandemic group had higher rates of emergency Caesarean sections (44.6% vs 23.5%, p=0.010) and neonatal hypoglycaemia (51.6% vs 34.3%, p=0.046). Both groups had good glycaemic control.
Conclusion: In women with pre-gestational diabetes, the rate of emergency Caesarean sections significantly increased during the pandemic, although compliance with scheduled antenatal visits and maternal and neonatal outcomes were similar before and during the pandemic. This suggests that the quality and accessibility of maternity care were not compromised by the pandemic.
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