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Evaluation of an Alternative Screening Method for Gestational Diabetes Diagnosis During the COVID-19 Pandemic

Alba Casellas1, Cristina Martínez2, Judit Amigó3

  • 1Maternal-Foetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, 08036 Barcelona, Spain.

Diagnostics (Basel, Switzerland)
|January 25, 2025
PubMed

Insights

An alternative gestational diabetes mellitus (GDM) screening method used during the COVID-19 pandemic showed lower GDM prevalence and comparable obstetrical and neonatal outcomes. This alternative approach was also more cost-effective than the standard method.

Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Public Health

Background:

  • The COVID-19 pandemic necessitated evaluating alternative diagnostic criteria for gestational diabetes mellitus (GDM).
  • Standard GDM screening methods were compared against an alternative approach utilizing plasma glucose and HbA1c.
  • The study assessed GDM prevalence, maternal-fetal outcomes, and economic impact in Catalonia, Spain.

Purpose of the Study:

  • To compare an alternative GDM diagnostic method with the standard method during the COVID-19 pandemic.
  • To evaluate the impact on GDM prevalence, obstetrical and perinatal outcomes, and healthcare costs.
  • To analyze outcomes in both the general pregnant population and a subgroup diagnosed with GDM.

Main Methods:

  • A comparative cohort study involving pregnant individuals screened for GDM using standard versus alternative methods (plasma glucose and HbA1c).
  • Data collected from 1543 (standard) and 2197 (alternative) participants across six hospitals in Spain (April 2020-April 2022).
  • Primary outcome: large for gestational age rate; secondary outcomes: composite adverse maternal and neonatal complications, and cost analysis.

Main Results:

  • The alternative screening method identified a lower GDM prevalence (6.9%) compared to the standard method (10.8%).
  • No significant differences were observed in large for gestational age rates or composite adverse outcomes (pregnancy, delivery, neonatal complications) between the groups.
  • The alternative screening method was significantly more cost-effective, with a mean cost of 46.0 euros versus 85.6 euros for the standard method.

Conclusions:

  • The alternative GDM screening method resulted in lower diagnosed prevalence without compromising obstetrical or neonatal outcomes during the pandemic.
  • This alternative approach offers a potentially more economical screening strategy for gestational diabetes mellitus.
  • Findings suggest the feasibility and benefits of the alternative GDM diagnostic criteria in a real-world clinical setting during public health crises.

Keywords:
COVID-19OGTTO’Sullivangestational diabetesglucose levelglycated hemoglobinlarge for gestational age (LGA)macrosomianeonatal hypoglycemiascreening

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