Impact of the COVID-19 lockdown on the O'Sullivan test and gestational diabetes mellitus diagnosis in pregnant Spanish women

Abstract

OBJECTIVE: To analyze the impact of COVID-19 lockdown on serum glucose levels of pregnant women. DESIGN: A retrospective analysis of O'Sullivan test in pregnant women who underwent COVID-19 lockdown compared to controls. SITE: Poniente Primary Health Care center in Córdoba (Spain). PARTICIPANTS: 235 pregnant women from 23(+0) to 25(+0) weeks of gestation without diabetes mellitus. INTERVENTIONS: Gestational diabetes mellitus screening with O'Sullivan test and 3-h oral glucose tolerance test. MAIN MEASUREMENTS: Pregnant women who underwent gestational diabetes mellitus screening with O'Sullivan test before (control group) and during COVID-19 Lockdown (Lockdown group) in Córdoba (Spain) were investigated. Lockdown group was divided in early and late lockdown. An additional, control group from data of the same months of the Lockdown in the previous year were recorded to discarded seasonally (adjusted seasonally control) this group was also divided in early and late seasonally adjusted. A logistic regression model for O'Sullivan test has been performed to analyze potential cofounders. Kolgomorov-Smirnov and Kruskal-Wallis test comparing pregnant women who underwent COVID-19 lockdown with the two types of controls. RESULTS: Statistically significant differences were found in serum glucose after O'Sullivan test between lockdown group and control group (123.51±26.02mg/dL and 112.86±31.28mg/dL; p=0.017). When early lockdown group and control group were compared no differences were found (119.64±26.18mg/dL vs. 112.86±31.28mg/dL; p>0.05) whereas differences were observed in late lockdown group and control group (127.22±25.59mg/dL vs. 112.86±31.28mg/dL; p=0.009). Statistical trends were also found between lockdown group and seasonally adjusted group and between lockdown and late seasonally adjusted group (p=0.089). A higher proportion of positive O'Suvillan pregnant women who were subsequently diagnosed with GDM were found in lockdown group compared to the seasonally adjusted control group (60% vs. 26.06% respectively; p<0.05). CONCLUSIONS: The COVID-19 lockdown was associated with an increase in serum glucose levels after the O'Sullivan test as well as a higher GDM diagnosis risk in pregnant women. The findings of our study emphasize the essential requirement for comprehensive maternal services and the accessibility to community's health assets during future lockdown scenarios to pregnant women.