Gestational Diabetes Mellitus Prevalence and the COVID-19 Pandemic: Characterizing Medical and Socioeconomic Risk Factors

Objective: Emerging evidence suggests a possible link between the COVID-19 pandemic and a rise in GDM prevalence, however, this relationship is not well characterized. This study assesses socioeconomic and medical risk factors associated with GDM across phases of the COVID-19 pandemic. Design: A retrospective cohort of all maternal deliveries from October 2015 - May 2022 was stratified between Pre-Pandemic, Lockdown, and Post Lockdown phases. Maternal demographics, gestational characteristics, and medical pregnancy complications were assessed. Setting: Sutter Sacramento Medical Center, a large community hospital in Sacramento, CA. Population: All maternal deliveries from October 2015 through May 2022 were included. Methods: Contingency tables, Χ 2 tests of independence, and logistic regression models were applied for data analysis. Main Outcome Measures: A total of 41,246 deliveries were evaluated. GDM prevalence was 5.4% overall (4.1% Pre-Pandemic, 7.6% Lockdown, 7.1% Post Lockdown). Results: Adjusted odds of GDM were 1.62 in Lockdown (95% CI:1.41-1.85) and 1.462 in Post Lockdown (95% CI:1.307-1.635). Variables associated with GDM included maternal age ≥35 years, Hispanic ethnicity, Asian or "Other" race, obesity, multiple gestation, PCOS, and preeclampsia. Risk factors for GDM were similar across the three periods. Conclusions: The surge in GDM prevalence observed during the Lockdown and Post Lockdown periods was not fully explained by identified socioeconomic and medical risk factors. COVID-19 pandemic-specific factors may underlie these trends.