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COVID-19 大流行对卡斯蒂利亚-拉曼恰(西班牙)妊娠期糖尿病的影响。

Effects of the COVID-19 pandemic on gestational diabetes in Castilla-La Mancha (Spain).

机构信息

Servicio de Endocrinología y Nutrición, Hospital Virgen de la Luz, Cuenca, Spain.

Servicio de Endocrinología y Nutrición, Hospital Virgen de la Salud, Toledo, Spain.

出版信息

Endocrinol Diabetes Nutr (Engl Ed). 2024 Feb;71(2):53-60. doi: 10.1016/j.endien.2024.03.005. Epub 2024 Mar 16.

Abstract

SUBJECT-MATTER: To assess the effect of the 2019 coronavirus (COVID-19) pandemic on gestational diabetes (GDM).

MATERIAL AND METHODS

In this retrospective, multicentre, non-interventional study carried out in Castilla-La Mancha, Spain, we compared 663 women with GDM exposed to the pandemic (pandemic group), with 622 women with GDM seen one year earlier (pre-pandemic group). The primary endpoint was a Large for Gestational Age (LGA) newborn as an indicator of poor GDM control. Secondary endpoints included obstetric and neonatal complications.

RESULTS

During the pandemic, the gestational week at diagnosis (24.2 ± 7.4 vs 22.9 ± 7.7, p = 0.0016) and first visit to Endocrinology (26.6 ± 7.2 vs 25.3 ± 7.6, p = 0.0014) were earlier. Face-to-face consultations were maintained in most cases (80.3%). The new diagnostic criteria for GDM were used in only 3% of cases. However, in the pandemic group, the final HbA1c was higher (5.2 ± 0.48 vs 5.29 ± 0.44%, p = 0.047) and there were more LGA newborns (8.5% vs 12.8%, p = 0.015). There were no differences in perinatal complications.

CONCLUSIONS

Care for GDM in our Public Health System did not significantly deteriorate during the COVID-19 pandemic. However, this did not prevent a higher number of LGA newborns.

摘要

研究目的

评估 2019 年冠状病毒病(COVID-19)大流行对妊娠期糖尿病(GDM)的影响。

材料和方法

本回顾性、多中心、非干预性研究在西班牙卡斯蒂利亚-拉曼恰进行,共纳入 663 例 GDM 孕妇(大流行组)和 622 例 GDM 孕妇(大流行前组)。主要终点为巨大儿(LGA)新生儿,作为 GDM 控制不良的指标。次要终点包括产科和新生儿并发症。

结果

大流行期间,诊断时的孕周(24.2±7.4 vs 22.9±7.7,p=0.0016)和首次就诊内分泌科的孕周(26.6±7.2 vs 25.3±7.6,p=0.0014)更早。大多数情况下仍保持面对面就诊(80.3%)。仅 3%的病例使用了新的 GDM 诊断标准。然而,大流行组的最终 HbA1c 更高(5.2±0.48 vs 5.29±0.44%,p=0.047),LGA 新生儿更多(8.5% vs 12.8%,p=0.015)。围产期并发症无差异。

结论

在 COVID-19 大流行期间,我们的公共卫生系统对 GDM 的管理并未显著恶化。然而,这并未防止更多的 LGA 新生儿出现。

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