Zhang Lixia, Shen Yun, Horswell Ronald, Lin Jessica, Chu San, Dumas S Amanda, Hu Gang
Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.
Womens Health Rep (New Rochelle). 2025 Apr 28;6(1):504-514. doi: 10.1089/whr.2025.0019. eCollection 2025.
This study aimed to evaluate the joint associations of maternal hyperglycemic and hypertensive disorders with adverse pregnancy outcomes across the coronavirus disease 2019 (COVID-19) pandemic.
This retrospective study included 110,447 Louisiana Medicaid pregnant women with first-time delivery from January 1, 2016, to December 31, 2021. Associations between hyperglycemic as well as hypertensive disorders and adverse pregnancy outcomes in pregnancy during prepandemic, early pandemic, and late pandemic were assessed by binary logistic regression.
The odds ratios of above adverse pregnancy outcomes were significantly higher during the early and late COVID-19 pandemic than those before the pandemic. Maternal gestational diabetes mellitus and diabetes before pregnancy were associated with higher risks of preterm birth, primary cesarean section, large for gestational age (LGA), macrosomia, neonatal hypoglycemia, neonatal jaundice, and neonatal respiratory distress syndrome (NRDS; all < 0.05), respectively, compared with women with normal glucose during pregnancy. Maternal gestational hypertension, preeclampsia or eclampsia, and pre-existing hypertension were associated with higher risks of preterm birth, primary cesarean section, low birth weight (exception for gestational hypertension), small for gestational age, LGA (exception for preeclampsia or eclampsia), macrosomia (exception for preeclampsia or eclampsia), neonatal hypoglycemia, neonatal jaundice, and NRDS (all < 0.05), respectively, compared with women with normal blood pressure during pregnancy. Most of these associations during the early and late pandemic were consistent with those before the COVID-19 pandemic.
Maternal hyperglycemic and hypertensive disorders during pregnancy, compared with maternal normal glucose or blood pressure during pregnancy, were associated with higher risks of adverse maternal and neonatal outcomes. Interventions should be taken to help individuals achieve glycemic and blood pressure control to decrease the risk of adverse perinatal outcomes regardless of the COVID-19 pandemic.
本研究旨在评估2019冠状病毒病（COVID-19）大流行期间，孕产妇高血糖和高血压疾病与不良妊娠结局的联合关联。
这项回顾性研究纳入了2016年1月1日至2021年12月31日在路易斯安那州首次分娩的110447名医疗补助孕妇。通过二元逻辑回归评估大流行前、大流行早期和晚期妊娠期间高血糖以及高血压疾病与不良妊娠结局之间的关联。
COVID-19大流行早期和晚期上述不良妊娠结局的比值比显著高于大流行之前。与孕期血糖正常的女性相比，孕产妇妊娠期糖尿病和孕前糖尿病分别与早产、首次剖宫产、大于胎龄儿（LGA）、巨大儿、新生儿低血糖、新生儿黄疸和新生儿呼吸窘迫综合征（NRDS；均P<0.05）的风险较高有关。与孕期血压正常的女性相比，孕产妇妊娠期高血压、子痫前期或子痫以及既往高血压分别与早产、首次剖宫产、低出生体重（妊娠期高血压除外）、小于胎龄儿、大于胎龄儿（子痫前期或子痫除外）、巨大儿（子痫前期或子痫除外）、新生儿低血糖、新生儿黄疸和NRDS（均P<0.05）的风险较高有关。大流行早期和晚期的大多数这些关联与COVID-19大流行之前的关联一致。
与孕期血糖或血压正常的孕产妇相比，孕期高血糖和高血压疾病与孕产妇和新生儿不良结局的风险较高有关。无论COVID-19大流行如何，都应采取干预措施帮助个体实现血糖和血压控制，以降低不良围产期结局的风险。
