Results
Baseline characteristics of the study population are depicted in Table 1. Altogether, 26/75 (34.66%) of the patients in the case group suffered from gestational diabetes vs. 24/149 (16.1%) in the control group (p=0.002). The rate of preterm delivery was 17.3% in the case group vs. 7.6% in the control group (p=0.04). Neonatal outcomes were collected in all the other women and are also summarized in Table 1.
Multivariate logistic regression analysis showed that SARS-CoV-2 (OR (95%CI) 2.79 (1.42, 5.47), p=0.003) and BMI (OR (95%CI) 1.12 (1.05, 1.19), p=0.001) were significant independent risk factors for GDM (Table 2).
In 11/75 (14.66%) patients, SARS-CoV-2 infection occurred in the first trimester of gestation, in 19/75 (25.33%) in the second and in 37/75 (49.33%) in the third trimester. In eight patients, time-point of infection was unknown (10.66%). Of these, three suffered from GDM.
Out of 28 patients infected with COVID-19 ≤ 26 week of pregnancy, 10 (35.7%) had a positive OGTT (GDM diagnosis) afterwards. This is similar to the 13/39 (33.3%) of patients with positive OGTT before infected with COVID (Chi-Square 0.84) (Table 3, Figure 1).
89.33% of the patients (67/75) in the case group suffered from asymptomatic, mild or moderate SARS-CoV-2 infection, according to the National Institutes of Health ( NIH) criteria for severity of the disease [14]. 12% (9/75) of the patients had severe or critical illness with inpatient management. Of these, 5.33% (4/75) required intensive care unit (ICU) admission and ventilation. These four patients underwent an emergency delivery because of SARS-CoV-2 infection. No patient deaths were recorded.
Of the nine patients with inpatient management, four (44.44%) suffered from GDM. Of the four patients who required admission at the ICU, two suffered from GDM (50%). Regression analysis of factors associated with inpatient COVID-19 management (inpatient vs. outpatient) showed no significance for GDM, time-point of infection or BMI (Table 4).