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

IF 3.7 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

BMJ Open Diabetes Research & Care Pub Date : 2024-01-01 DOI:10.1136/bmjdrc-2023-003724

Tatjana P Liedtke, Katharina S Weber, Heinke Adamczewski, Dietmar Weber, Babett Ramsauer, Ute M Schaefer-Graf, Tanja Groten, Eike A Strathmann, Wolfgang Lieb, Mario Rüdiger, Ulrich Pecks, Helmut J Kleinwechter

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引用次数: 0

Abstract

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. No data are available. Not provided due to data protection reasons.

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孕期感染或未感染 SARS-CoV-2 的妊娠糖尿病患者的围产期不良结局：德国两个全国性登记的结果

导言：众所周知，妊娠是 COVID-19 严重病程的一个独立危险因素。SARS-CoV-2 感染与妊娠糖尿病（GDM）对新生儿预后的关系尚不清楚。我们的目的是确定 SARS-CoV-2 感染是否是妊娠合并 GDM 的围产期不良结局的独立风险因素。研究设计和方法我们比较了两个德国登记处的数据，其中包括在 SARS-CoV-2 大流行期间建立的 GDM 孕妇登记处（COVID-19 相关产科和新生儿结局研究 (CRONOS)，一项多中心前瞻性观察研究）和在大流行之前已经存在的 GDM 孕妇登记处（德国 GDM 孕妇登记处；GestDiab）。共有 409 名 GDM 和 SARS-CoV-2 感染者以及 4598 名 2018-2019 年登记的 GDM 患者符合分析条件。主要的胎儿和新生儿结局定义为：(1）合并：入住新生儿重症监护室、死产和/或新生儿死亡；（2）妊娠 37+0 周前早产。胎龄大、胎龄小、母体胰岛素治疗、出生体重大于 4500 克和剖宫产被视为次要结果。结果感染 SARS-CoV-2 的妇女更年轻（32 岁对 33 岁），体重指数中位数更高（28 公斤/平方米对 27 公斤/平方米）。在 CRONOS 中，更多新生儿出现主要结果（调整 OR (aOR) 1.48，95% CI 1.11 至 1.97）和早产（aOR 1.50，95% CI 1.07 至 2.10）。CRONOS孕妇的空腹血糖高于GestDiab孕妇（5.4 mmol/L vs 5.3 mmol/L），每增加0.1 mmol/L，仅CRONOS孕妇的早产风险就会增加5%（aOR为1.05，95% CI为1.01至1.09）。结论与未感染 SARS-CoV-2 的 GDM 相比，妊娠期感染 SARS-CoV-2 的 GDM 与胎儿和新生儿不良预后风险增加有关。无数据。因数据保护原因未提供。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

9.30

自引率

2.40%

发文量

123

审稿时长

18 weeks

期刊介绍： BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.