Related Experiment Video
Updated: Jun 16, 2026
A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
Published on: July 5, 2022
COVID-19 lockdowns and gestational diabetes risk: trimester-specific exposure and stratified outcomes
Omri Dominsky1,2, Yariv Yogev3,4, Liat Lerner-Geva5
1Department of Obstetrics and Gynecology, Lis Hospital for Women's Health, Sourasky University Medical Center (Ichilov), Tel Aviv, Israel. omrid@tlvmc.gov.il.
Insights
The COVID-19 pandemic increased gestational diabetes mellitus (GDM) risk, particularly with first-trimester lockdown exposure. This highlights the need for enhanced pregnancy support during public health crises.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic significantly impacted lifestyle factors crucial for managing gestational diabetes mellitus (GDM).
- Disruptions in physical activity, nutrition, and increased stress are known determinants of GDM.
- The pandemic's influence on GDM prevalence and associated risk factors required urgent investigation.
Purpose of the Study:
- To determine the association between pandemic-period delivery and GDM prevalence.
- To investigate the specific impact of national lockdown exposure during pregnancy on GDM risk.
- To analyze secondary outcomes such as cesarean delivery and macrosomia in relation to the pandemic.
Main Methods:
- A historical cohort study was conducted, comparing singleton deliveries before (April 2018-October 2019) and during (April 2020-October 2021) the COVID-19 pandemic.
- GDM diagnosis followed standardized two-step screening.
- Multivariable logistic regression models adjusted for key maternal factors, with trimester-specific lockdown exposure assessed.
Main Results:
- GDM prevalence rose from 5.4% pre-pandemic to 7.8% during the pandemic (p < 0.001).
- Pandemic-period delivery remained significantly associated with increased GDM risk (adjusted OR 1.29).
- First-trimester lockdown exposure demonstrated the strongest association with GDM (adjusted OR 1.6).
Conclusions:
- Pandemic-period delivery is linked to higher GDM rates, independent of gestational weight gain, possibly due to stress and lifestyle changes.
- Early pregnancy lockdown exposure is a significant risk factor for GDM.
- Findings emphasize the necessity of robust public health interventions, including digital health and mental health support, during health emergencies.
Background:
The COVID-19 pandemic disrupted physical activity, nutrition, and stress, key determinants of gestational diabetes mellitus (GDM). We examined whether pandemic-period delivery and lockdown exposure were associated with GDM prevalence.
Methods:
We conducted a historical cohort study at a tertiary medical center including singleton deliveries ≥ 24 weeks during April 2018-October 2019 (pre-pandemic) and April 2020-October 2021 (pandemic). The pandemic period encompassed three national lockdowns. The primary outcome was GDM diagnosed using standardized two-step screening. Secondary outcomes included cesarean delivery and macrosomia. Multivariable logistic regression adjusted for maternal age, pre-pregnancy BMI, parity, chronic hypertension, and pre-gestational diabetes. Trimester-specific lockdown exposure was assessed.
Results:
Among 31,060 deliveries (15,190 pre-pandemic; 15,870 pandemic), GDM prevalence increased from 5.4% to 7.8% (p < 0.001). After adjustment, the association remained significant (adjusted OR 1.29, 95% CI 1.12-1.49). First-trimester lockdown exposure showed the strongest association (adjusted OR 1.6, 95% CI 1.3-2.0). Despite rising GDM, cesarean delivery rates and macrosomia remained stable, though cesarean for suspected macrosomia increased (5.7% to 8.1%, p < 0.001). Mean gestational weight gain did not differ between periods.
Conclusions:
Pandemic-period delivery was associated with increased GDM independent of gestational weight gain, potentially related to stress-mediated metabolic dysregulation, dietary quality changes, or reduced physical activity beyond caloric excess. First-trimester lockdown exposure showed the strongest association with GDM risk. These findings underscore the need for proactive interventions during public health emergencies, including digital health infrastructure, early pregnancy support, and integrated mental health care.
Related Concept Videos
01:22Diabetes Mellitus: Type 2 and Gestational
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...
01:26Type II Diabetes I: Introduction
01:22Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
01:26Diabetes Mellitus: Introduction
01:19Overview of Carbohydrate Metabolism
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...