Impact of new diagnostic pathway for gestational diabetes in time of COVID-19

Background: In April 2020, the diagnostic criteria for gestational diabetes mellitus (GDM) changed in Queensland, with the goal of reducing exposure of pregnant women to COVID-19. Methods: A retrospective clinical audit was conducted at a regional hospital to compare the incidence of GDM, and specific maternal and neonatal outcomes four months before and after the change in guidelines was implemented. Results: Less than 50% of diagnostic tests were performed according to new guidelines. There was a non-significant increase in the incidence of GDM (13.3% to 15.3%), and pharmacological treatments. Instrumental deliveries (p = 0.01) and shoulder dystocia (p = 0.04) increased following the change in guidelines. There were no differences in the incidence of elective and emergency caesarean delivery, macrosomia and fetal weight. Maternal pre-pregnancy body mass index (BMI) was higher in the COVID-19 GDM cohort (p = 0.02). Conclusions: Despite the change in guidelines, there was a non-significant increase in the incidence of diagnosis of gestational diabetes.