Maternal-fetal medicine (Wolters Kluwer Health, Inc.) · 2025
Time-Varying Association of Acute and Post-Acute COVID-19 With Gestational Diabetes Mellitus.
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He Yilin, Wang Chen, Juan Juan, Yan Jie, Yang Huixia
Аннотация
OBJECTIVE: To investigate whether coronavirus disease 2019 (COVID-19) infection increases the risk of gestational diabetes mellitus (GDM) in pregnant women and to assess whether this risk persists beyond the acute phase of infection.
METHODS: A retrospective cohort study was conducted at Peking University First Hospital between January and February 2023, enrolling pregnant women who contracted COVID-19 between 16 and 32 weeks of gestation. The primary exposure was the time interval between the oral glucose tolerance test (OGTT) and the onset of COVID-19 infection. The primary outcome was the diagnosis of GDM based on OGTT results. A locally weighted scatterplot smoothing method was applied to visualize trends, and logistic regression was used to estimate odds ratios (ORs).
RESULTS: The incidence of GDM increased from 23.1% (18/78) in women who underwent OGTT before COVID-19 infection to 36.6% (37/101) in those tested after infection (P = 0.051). All OGTT values were elevated post-infection, with postprandial glucose levels showing the most pronounced rise. As the time since infection increased, OGTT values gradually normalized. The elevated risk of GDM decreased over time: OR for 1-2 weeks post-infection was 3.58 (95% confidence interval: 1.27-10.23); 3-4 weeks: 2.47 (1.04-5.94); 5-6 weeks: 1.45 (0.44-4.41); and 7-8 weeks: 0.41 (0.08-1.55).
CONCLUSION: COVID-19 infection was associated with a transiently increased risk of GDM, particularly within the first month following symptom onset, suggesting that the infection may have a short-term impact on glucose metabolism during pregnancy.
METHODS: A retrospective cohort study was conducted at Peking University First Hospital between January and February 2023, enrolling pregnant women who contracted COVID-19 between 16 and 32 weeks of gestation. The primary exposure was the time interval between the oral glucose tolerance test (OGTT) and the onset of COVID-19 infection. The primary outcome was the diagnosis of GDM based on OGTT results. A locally weighted scatterplot smoothing method was applied to visualize trends, and logistic regression was used to estimate odds ratios (ORs).
RESULTS: The incidence of GDM increased from 23.1% (18/78) in women who underwent OGTT before COVID-19 infection to 36.6% (37/101) in those tested after infection (P = 0.051). All OGTT values were elevated post-infection, with postprandial glucose levels showing the most pronounced rise. As the time since infection increased, OGTT values gradually normalized. The elevated risk of GDM decreased over time: OR for 1-2 weeks post-infection was 3.58 (95% confidence interval: 1.27-10.23); 3-4 weeks: 2.47 (1.04-5.94); 5-6 weeks: 1.45 (0.44-4.41); and 7-8 weeks: 0.41 (0.08-1.55).
CONCLUSION: COVID-19 infection was associated with a transiently increased risk of GDM, particularly within the first month following symptom onset, suggesting that the infection may have a short-term impact on glucose metabolism during pregnancy.