Gestational diabetes is associated with SARS-CoV-2 infection during
pregnancy: A case-control study
Abstract
Objective: to investigate a possible bi-directional association between
gestational diabetes (GDM) and the SARS-CoV-2 infection during
pregnancy. Design: case-control study with prospective data collection
for the case group and 1:2 matching with historical controls Setting:
University Hospital of Bern, Switzerland Population: 224 pregnant women:
75 cases with SARS-CoV-2 infection during pregnancy, matched 1:2 with
controls based on parity, BMI and ethnicity. Methods: SARS-CoV-2
infection was diagnosed by RT-PCR. Screening for GDM was performed by
75mg oral glucose tolerance test at 26 weeks’ gestation in all women.
Main Outcomes: Prevalence of GDM was calculated in both groups.
Multivariate binary logistic regression analysis was performed to assess
risk factors for GDM and inpatient COVID-19 management. Results: 34.6%
of the patients in the case group suffered from GDM, vs. 16.1% in the
control group (p=0.002). 35.7% patients were diagnosed with GDM after
the SARS-CoV-2 infection, vs. 33.3% diagnosed before infection
(OR(95%CI) 1.11(0.40-3.08), p=0.84), with no correlation between the
time-point of infection and GDM diagnosis. SARS-CoV-2 (OR(95%CI) 2.79
(1.42, 5.47), p=0.003) and BMI (OR(95%CI) 1.12 (1.05, 1.19), p=0.001)
were significant independent risk factors for GDM. Conclusions: The
significantly higher rate of GDM among women with SARS-CoV-2 infection
during pregnancy, as compared to matching controls, suggests that GDM
increases the risk of infection. On the other hand, SARS-CoV-2 during
pregnancy might increase the risk of developing GDM. Vaccination and
caution in using protective measures should be recommended to pregnant
women, particularly those with co-morbidities. Funding: none Keywords:
SARS-CoV-2, gestational diabetes, COVID-19