Endocrine Abstracts

Introduction: Researchers argue that increased morbidity is noted in pregnant women during the current COVID-19 pandemic. Reports indicate that the pandemic has led to disruptions in care of persons with diabetes. Glycated hemoglobin A1c (A1c) is not sufficient in screening for gestational diabetes mellitus (GDM) but may be of use in monitoring glycemia in GDM. To the best of our knowledge no studies honed on late pregnancy glycemia (via A1c), as a surrogate of the access/quality of care for women with GDM, have been put forth.

Aim: To assess whether care for women with GDM during the COVID-19 era (via measurement of A1c in late pregnancy) was compromised, compared to the pre-COVID-19 period.

Subjects & Methods: We accessed the medical records of 90 pregnant women (49 before and 41 during the COVID-19 era; mean age+SD: 34.01+5.50 years) with GDM, in whom A1c was measured after the 34th week of pregnancy. We noted the following parameters: age, body weight change (diffBW) during pregnancy, presence of thyroid disease and treatment (nutrition therapy only [NT] or combined with insulin [INS]). Statistical evaluation was done with two way analysis of variance (ANOVA), analysis of covariance (ANCOVA) and with the chi square test.

Results: Fifteen of 49 and 15/49 women in the preCOVID-19 era had thyroid disease and were on INS, respectively, whereas 10/41 and 20/41 in the COVID-19 era had thyroid disease and were on INS, respectively (P > 0.1, Chi square). Mean+SD A1c was 5.26%+0.42% before and 5.37%+0.58% during the COVID-19 era (P > 0.10, ANCOVA), with no significant effect or differences in age, diffBW or presence of thyroid disease (P > 0.1 ANCOVA). The only factor that had an effect on A1c was the mode of treatment (NT or INS) both in the pre-COVID-19 era and in the COVID-19 era; women on INS had higher A1c in both time periods (P = 0.001, ANOVA).

Discussion: As far as late pregnancy glycemia, via A1c, is concerned, no effect of the COVID-19 era on care for women with GDM was noted. Although we have to acknowledge the non-inclusion of other parameters in our study such as perinatal outcomes, our results are in accordance with studies that show no effect of COVID-19 on adverse outcomes in pregnancy during the COVID-19 era in high-income countries (in contrast to mid/lower income ones).