Poster Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2021

GDM and the COVID-19 pandemic – An audit of pregnancy outcomes (#95)

Tang Wong 1 2 3 , Sarah Abdo 1 3 , Robyn Barnes 1 4 , Laura Kourloufas 1 , Sabina John 1 , Androulla Nicodemou 1 , Stephanie Terry 1 , Jenny Wright 1 5 , Jeff Flack 1 2 3
  1. Department of Diabetes and Endocrinology, Bankstown-Lidcombe Hospital, Sydney, NSW, Australia
  2. University of NSW, Sydney, Australia
  3. Western Sydney Univerisity, Sydney, NSW, Australia
  4. University of Newcastle, Newcastle, NSW, Australia
  5. University of Technology, Sydney, NSW, Australia

Background: During the COVID-19 pandemic, the model of care for Gestational Diabetes (GDM) management at Bankstown-Lidcombe Hospital was adapted to include telehealth consultations to minimise unnecessary face to face interactions and mitigate contagion risk.

 

Aim: Assessment of pregnancy outcomes before and during the COVID-19 pandemic.

 

Methods: We analysed prospectively collected data of singleton GDM pregnancies (IADPSG/WHO2013 criteria). The pre-COVID period defined as March 2016-February 2020 and COVID period from March 2020-March 2021.

 

Baseline characteristics evaluated included age, ethnicity, pre-pregnancy BMI, gestational age at GDM diagnosis, diagnosis of GDM<20 weeks, HbA1c and 75g OGTT result. Outcomes assessed were need for insulin therapy, number of medical reviews, incidence of excessive weight gain(EGWG) during pregnancy(per IOM), pre-term delivery(<37 weeks) and caesarean section. Neonatal outcomes included infant gender, birthweight, small(SGA, <10th percentile) and large for gestational age(LGA, >90th percentile), shoulder dystocia, neonatal hypoglycaemia and jaundice. Independent sample t-tests and Chi-square/Fisher’s exact tests were used for continuous and categorical data respectively. P<0.05 indicated statistical significance.

 

Results:

1896 GDM women were included in this study, 292(15.4%) during COVID and 1604(84.6%) pre-COVID. During COVID, there was lower mean 1hr glucose(p<0.0001), 2hr glucose(p<0.001), HbA1c(p<0.001), later diagnosis of GDM(p<0.001) and a lower proportion diagnosed before 20 weeks(p<0.05) compared to pre-COVID. There were no other differences in baseline characteristics.

 

During the COVID period, there were similar rates of insulin use(48.6vs43.0%), number of medical reviews(7.0vs6.9 episodes), rates of EGWG(39.4vs36.0%), pre-term delivery(6.2vs 6.1), caesarean section(37.0vs34.6%), SGA(8.6vs8.4%), LGA(14.4vs11.4%), shoulder dystocia(1.0vs0.2%), neonatal hypoglycaemia(9.2vs10.2%) and neonatal jaundice (3.8vs5.0%) compared to pre-COVID(all outcomes, p=NS)

 

Conclusions: Increased use of teleconferencing during the initial 12 months of the COVID pandemic lead to similar pregnancy outcomes compared to the pre-COVID period. A model of care involving teleconferencing is likely to be retained as the “new-normal” in a post-COVID world. Future audits will ascertain whether comparable outcomes are maintained.