Impact of a modified screening approach during the COVID‐19 pandemic on the diagnosis and outcomes of gestational diabetes mellitus: A population‐level analysis of 90,518 pregnant women

Abstract

AimsTo provide real‐world evidence on the uptake of, and outcomes associated with the modified gestational diabetes mellitus (GDM) screening approach offered during the COVID‐19 pandemic compared with the standard screening approach.MethodsAll pregnancies between 01.01.2020 and 31.12.2021, in Alberta, Canada, were included in the study. We examined GDM screening and diagnosis rates, and large‐for‐gestational‐age (LGA) outcomes.ResultsAnnual GDM screening rates were >95% during the study time period. Overall, 84.7%, and 11.6% of the 92,505 pregnancies underwent standard‐ and modified‐screening for GDM, respectively. The use of modified‐screening was highest among deliveries in August 2020 (49.8%) which corresponded to the early first wave of the pandemic. GDM diagnosis rate was lower in the modified‐screening (7.4%) than in the standard‐screening (12.3%, p<0.001) group. The LGA rates in the modified‐screening with GDM and the standard‐screening with GDM groups were 24.8% and 12.6%, respectively (p<0.001). Women in the modified‐screening with GDM group were at a higher risk of having an LGA infant (adjusted OR: 3.46; 95% CI: 2.93, 4.08) compared to the standard‐screening with no GDM group.ConclusionsThe COVID‐19 epidemic had no impact on screening for GDM. Women who underwent modified screening, based on HbA1c/random plasma glucose, had lower rates of GDM cases.