Adverse perinatal outcomes in gestational diabetes mellitus with and without SARS-CoV-2 infection during pregnancy: results from two nationwide registries in Germany.

Autor:	Liedtke TP; Institute for Epidemiology, Kiel University, Kiel, Germany., Weber KS; Institute for Epidemiology, Kiel University, Kiel, Germany., Adamczewski H; Scientific Institute of Diabetologists in Practice, Kaarst, Germany., Weber D; Scientific Institute of Diabetologists in Practice, Kaarst, Germany., Ramsauer B; Department of Gynecology and Obstetrics, Vivantes Clinic Neukölln, Berlin, Germany., Schaefer-Graf UM; Department of Obstetrics, Berlin Diabetes Center for Pregnant Women, St. Joseph Hospital, Berlin, Germany., Groten T; Department of Obstetrics, Competence Center for Diabetic Women, Jena University Hospital, Jena, Germany., Strathmann EA; Institute for Epidemiology, Kiel University, Kiel, Germany., Lieb W; Institute for Epidemiology, Kiel University, Kiel, Germany., Rüdiger M; Saxony Center for Fetal-Neonatal Health, Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University, Dresden, Germany., Pecks U; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.; Maternal Health and Midwifery Science, Julius Maximilians University of Würzburg, Würzburg, Germany., Kleinwechter HJ
Jazyk:	angličtina
Zdroj:	BMJ open diabetes research & care [BMJ Open Diabetes Res Care] 2024 Jan 25; Vol. 12 (1). Date of Electronic Publication: 2024 Jan 25.
DOI:	10.1136/bmjdrc-2023-003724
Abstrakt:	Introduction: Pregnancy is a known independent risk factor for a severe course of COVID-19. The relationship of SARS-CoV-2 infection and gestational diabetes mellitus (GDM) on neonatal outcomes is unclear. Our aim was to determine if SARS-CoV-2 infection represents an independent risk factor for adverse perinatal outcomes in pregnancy with GDM. Research Design and Methods: We compared data from two German registries including pregnant women with GDM, established during the SARS-CoV-2 pandemic (COVID-19-Related Obstetric and Neonatal Outcome Study (CRONOS), a multicenter prospective observational study) and already existing before the pandemic (German registry of pregnant women with GDM; GestDiab). In total, 409 participants with GDM and SARS-CoV-2 infection and 4598 participants with GDM, registered 2018-2019, were eligible for analyses. The primary fetal and neonatal outcomes were defined as: (1) combined: admission to neonatal intensive care unit, stillbirth, and/or neonatal death, and (2) preterm birth before 37+0 weeks of gestation. Large and small for gestational age, maternal insulin therapy, birth weight > 4500 g and cesarean delivery were considered as secondary outcomes. Results: Women with SARS-CoV-2 infection were younger (32 vs 33 years) and had a higher median body mass index (28 vs 27 kg/m²). In CRONOS, more neonates developed the primary outcome (adjusted OR (aOR) 1.48, 95% CI 1.11 to 1.97) and were born preterm (aOR 1.50, 95% CI 1.07 to 2.10). Fasting glucose was higher in women in CRONOS versus GestDiab (5.4 vs 5.3 mmol/L) considering each 0.1 mmol/L increase was independently associated with a 5% higher risk of preterm birth among women in CRONOS only (aOR 1.05, 95% CI 1.01 to 1.09). Conclusions: GDM with SARS-CoV-2 infection in pregnancy is associated with an increased risk of adverse fetal and neonatal outcomes as compared with GDM without SARS-CoV-2 infection. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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