The association between COVID-19 and incident gestational diabetes (GDM): A population-based case-control study of the National Health Insurance Research Database in Taiwan.

BACKGROUND

Reports suggested that diabetes could be a complication arising from COVID-19; however, the relationship between COVID-19 and the development of gestational diabetes mellitus (GDM) remains unclear.

OBJECTIVES

This study aimed to investigate the association between COVID-19 infections and the risk of incident GDM in pregnant women.

METHODS

We analyzed data from Taiwan's National Health Insurance Research Database (NHIRD), which is linked to the Birth Reporting Database and the COVID-19 testing database between 2020 and 2022. A case-control study was conducted, matching pregnant women by age and region. We employed multivariable logistic regression, adjusting for matching factors and potential confounders. The findings were further validated through a sensitivity analysis using a cohort design with landmark analysis.

RESULTS

The study included 134,375 pregnant women, comprising 26,875 GDM cases and 107,500 matched controls. After adjusting for covariates, we found no evidence supporting an association between prior COVID-19 infection and incident GDM (adjusted odds ratio [aOR] = 0.95, 95% confidence interval [CI] = 0.89-1.01). Notably, some evidence showed that receiving at least one COVID-19 vaccination was associated with a decreased risk of GDM (aOR = 0.90, 95% CI = 0.87-0.93). These results remained consistent in the sensitivity analysis.

CONCLUSION

Despite COVID-19 now being endemic with less virulent variants, ongoing vigilance regarding potential pregnancy-related impacts of SARS-CoV-2 is essential. It is also critical to promote vaccination among women of childbearing age, and further research is necessary to explore COVID-19-related complications during pregnancy.