Impact of COVID-19 clinical care pathway changes on gestational diabetes incidence and pregnancy outcomes in England
During the COVID-19 pandemic, healthcare providers had to quickly adapt their approach to screening, diagnosing, and managing high blood sugar levels in pregnancy, known as gestational diabetes (GDM). To minimise the risk of viral exposure, care providers made changes to the way care was delivered. This included reducing the number of face-to-face contacts, as well as making pragmatic decisions about identifying and managing high blood sugar levels in pregnancy, to avoid serious problems for babies, particularly stillbirth and being born too large. The impact of these changes on pregnancy outcomes is unknown. Whilst there is concern that these changes may have led to poorer outcomes for women and their babies, there may be benefits to women from the introduction of screening tests earlier in pregnancy.
We will use routinely-collected healthcare data to determine the effect of changes in antenatal care during the COVID-19 pandemic on the occurrence of GDM and associated pregnancy outcomes in England. A particular focus of this work will be on outcomes for pregnant women and pregnant people from minority ethnic and low socioeconomic groups, as we know that these women and people have poorer pregnancy outcomes in general.
The results of this study will provide essential information needed to guide the design of future antenatal care as we emerge from the pandemic.
The issues stated above will be addressed in outputs from a number of related sub-projects. Follow the links below to view repositories containing the protocol, data curation and analysis code, and phenotyping algorithms and codelists for each sub-project:
This project has been approved by the CVD-COVID-UK/COVID-IMPACT Approvals & Oversight Board (Project ID: CCU064).