Atención Primaria (Dec 2024)
Impact of the COVID-19 lockdown on the O'Sullivan test and gestational diabetes mellitus diagnosis in pregnant Spanish women
Abstract
Objective: To analyze the impact of COVID-19 lockdown on serum glucose levels of pregnant women. Design: A retrospective analysis of O'Sullivan test in pregnant women who underwent COVID-19 lockdown compared to controls. Site: Poniente Primary Health Care center in Córdoba (Spain). Participants: 235 pregnant women from 23+0 to 25+0 weeks of gestation without diabetes mellitus. Interventions: Gestational diabetes mellitus screening with O'Sullivan test and 3-h oral glucose tolerance test. Main measurements: Pregnant women who underwent gestational diabetes mellitus screening with O'Sullivan test before (control group) and during COVID-19 Lockdown (Lockdown group) in Córdoba (Spain) were investigated. Lockdown group was divided in early and late lockdown. An additional, control group from data of the same months of the Lockdown in the previous year were recorded to discarded seasonally (adjusted seasonally control) this group was also divided in early and late seasonally adjusted.A logistic regression model for O'Sullivan test has been performed to analyze potential cofounders. Kolgomorov–Smirnov and Kruskal–Wallis test comparing pregnant women who underwent COVID-19 lockdown with the two types of controls. Results: Statistically significant differences were found in serum glucose after O'Sullivan test between lockdown group and control group (123.51 ± 26.02 mg/dL and 112.86 ± 31.28 mg/dL; p = 0.017). When early lockdown group and control group were compared no differences were found (119.64 ± 26.18 mg/dL vs. 112.86 ± 31.28 mg/dL; p > 0.05) whereas differences were observed in late lockdown group and control group (127.22 ± 25.59 mg/dL vs. 112.86 ± 31.28 mg/dL; p = 0.009). Statistical trends were also found between lockdown group and seasonally adjusted group and between lockdown and late seasonally adjusted group (p = 0.089). A higher proportion of positive O'Suvillan pregnant women who were subsequently diagnosed with GDM were found in lockdown group compared to the seasonally adjusted control group (60% vs. 26.06% respectively; p 0,05), mientras que sí se observaron diferencias en el grupo de confinamiento tardío y el grupo de control (127,22 ± 25,59 mg/dL frente a 112,86 ± 31,28 mg/dL; p = 0,009). También se encontraron tendencias estadísticas entre el grupo confinado y el grupo desestacionalizado y entre el grupo confinado y el grupo desestacionalizado tardío (p = 0,089). La proporción de embarazadas positivas al test de O'Suvillan a las que posteriormente se diagnosticó diabetes mellitus gestacional en el grupo de confinamiento fue mayor que el grupo de control desestacionalizado (60% frente a 26,06%, respectivamente; p < 0,05). Conclusiones: El confinamiento por el COVID-19 se asoció con un aumento de la glucosa sérica tras la prueba de O'Sullivan, así como un mayor riesgo de diagnóstico de diabetes mellitus gestacional en las mujeres embarazadas. Los hallazgos de nuestro estudio enfatizan la necesidad de servicios maternos integrales y el acceso a los activos para la salud de la comunidad durante futuros escenarios de confinamiento a mujeres gestantes.
