Postprandial Hyperglycaemia Screening and Pregnancy Outcomes-Lessons From COVID -19
Date
2025
Authors
Bastian, B.
Smithers, L.G.
Kunjunju, A.
Pape, A.
Francois, M.
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Australian and New Zealand Journal of Obstetrics and Gynaecology, 2025; ajo.70014-1-ajo.70014-8
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Beenu Bastian, Lisa Gaye Smithers, Ansar Kunjunju, Alexia Pape, Monique Francois
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Abstract
Background: During COVID-19, the diagnosis and treatment of GDM differed from conventional criteria. In Australia, during the alternative testing period, women with fasting glucose < 4.7 mmol/L were not diagnosed with GDM.Aim: To describe the maternal and neonatal outcomes of pregnant women with fasting blood glucose < 4.7 mmol/L for whom the diagnosis and treatment pathways differed before and during COVID-19.Materials and Methods: An Australian population-based data linkage study involving 3891 women with fasting blood glu-cose < 4.7 mmol/L between 24 and 32 weeks of gestation categorised into three groups: women diagnosed with GDM by postpran-dial hyperglycaemia (PPGDM; n = 226); normal glucose tolerance group (NGT; n = 3125) and women not tested for postprandial hyperglycaemia, mostly during COVID-19 (LFBG; n = 540). Perinatal outcomes were compared using generalised linear models.Results: There were no differences between PPGDM and NGT groups in the risk of large for gestational age infants (RR 0.98,95% CI: 0.63–1.52) although the mean birth weight (MD −103.43, 95% CI: −175.46 to −31.40)) was lower in the PPGDM group.The maternal and neonatal outcomes in the LFBG group were mostly comparable to the NGT group.Conclusion: In our study, the Australian COVID-19 GDM screening protocol, which includes initial fasting glucose testing,reduced the need for an OGTT in 67% of pregnant women. Diagnosis and treatment for postprandial hyperglycaemia in women with lower FBG should consider the benefits, as well as the financial, logistical and psychological costs involved.
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© 2025 The Author(s). Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.