Objective: To evaluate the impact of COVID-19 on the associations between maternal hyperglycemic and hypertensive disorders and adverse pregnancy outcomes.

Methods: This retrospective study included 110,447 Louisiana Medicaid pregnant women with first-time delivery between January 1, 2016, to December 31, 2021. Adverse pregnancy outcomes were collected through Medicaid claim data. Logistic regression adjusted for maternal age and race and ethnicity, with additional interaction analyses were used.

Results: Participants delivered during early and late COVID-19 pandemic had significantly higher risk of these adverse pregnancy outcomes except preterm birth compared with before the pandemic. The incremental risk of preterm birth associated with HDP during late pandemic is not significant (P > 0.10) as well as LGA (P > 0.25; P > 0.10) and macrosomia (P > 0.50; P > 0.10) during early and late pandemic. Participates with pre-existing hypertension delivered during late pandemic had no significant risk of preterm birth (adjusted OR, 1.09 [95% CI 0.86-1.36]). Individuals with normal blood pressure delivered during early pandemic and with preeclampsia or eclampsia delivered during late pandemic had higher risk of LGA (adjusted OR, 1.32 [95% CI, 1.19-1.47]; 1.56 [95% CI, 1.15-2.10]) and macrosomia (adjusted OR, 1.31 [95% CI, 1.18-1.45]; 1.55 [95% CI, 1.16-2.08]). Participates with gestational hypertension and pre-existing hypertension delivered during late pandemic had no significant risk of LGA (adjusted OR, 1.22 [95% CI, 0.86-1.73]; 1.24 [95% CI, 0.88-1.76]) and macrosomia (adjusted OR, 1.27 [95% CI, 0.91-1.77]; 1.18 [95% CI, 0.84-1.67]).

Conclusions: In this large population-based study, associations between hyperglycemic and hypertensive disorders in pregnancy and adverse pregnancy outcomes including preterm birth, LGA and macrosomia varied by COVID-19 pandemic periods.

Disclosure

L. Zhang: None. Y. Shen: None. G. Hu: None.

Funding

This study is supported by the grant from the Public University Partnership Program at the Louisiana Department of Health, Bureau of Health Services Financing. Dr. Hu is partially supported by the grant from the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK132011) and the National Institute of General Medical Sciences (U54GM104940).

© 2024 by the American Diabetes Association
2024
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