Introduction Coronavirus disease 2019 (COVID-19) may be associated with gestational diabetes mellitus (GDM); however, evidence is limited by sample sizes and lack of control groups. Methods To assess the GDM risk after COVID-19 in pregnancy, we constructed a retrospective cohort of pregnancies ending March 2020–October 2022 using medical claims. People with COVID-19 diagnosis claims from conception to 21 gestational weeks (n = 57 675) were matched 1:2 to those without COVID-19 during pregnancy (n = 115 350) by age range, pregnancy start month, and encounter year-month. GDM (claim ≥23 gestational weeks) relative risk and risk difference overall, by race and ethnicity, and variant period were estimated using log-binomial models. Results GDM risk was higher among those with COVID-19 during pregnancy compared to those without (adjusted risk ratio [aRR] = 1.12; 95% confidence interval [CI], 1.08–1.15). GDM risk was significantly associated with COVID-19 in non-Hispanic White (aRR = 1.08; 95% CI, 1.04–1.14), non-Hispanic Black (aRR = 1.15; 95% CI, 1.07–1.24), and Hispanic (aRR = 1.17; 95% CI, 1.10–1.24) groups. GDM risk was significantly higher during pre-Delta (aRR = 1.17; 95% CI, 1.11–1.24) compared to Omicron (aRR = 1.07; 95% CI, 1.02–1.13) periods, but neither differed from the Delta period (aRR = 1.10; 95% CI, 1.04–1.17). The adjusted risk difference was 0%–2% for all models. Conclusions COVID-19 during pregnancy was modestly associated with GDM in claims-based data, especially during earlier SARS-CoV-2 variant periods. Because these associations are based on COVID-19 in claims data, studies employing systematic testing are warranted.

中文翻译：

---

怀孕期间 SARS-CoV-2 感染与妊娠糖尿病之间的关联：一项基于索赔的队列研究


简介 2019 冠状病毒病 （COVID-19） 可能与妊娠糖尿病 （GDM） 有关;然而，证据受到样本量和缺乏对照组的限制。方法 为了评估妊娠期 COVID-19 后 GDM 风险，我们使用医疗声明构建了一个截至 2020 年 3 月至 2022 年 10 月的妊娠回顾性队列。从受孕到 21 孕周 （n = 57 675） 的 COVID-19 诊断索赔者与怀孕期间没有 COVID-19 的人 （n = 115 350） 按年龄范围、怀孕开始月份和遭遇年份月份进行 1：2 匹配。使用对数二项式模型估计 GDM （索赔 ≥23 孕周） 相对风险和总体风险差异，按种族和民族以及变异期。结果 与未感染 COVID-19 的人相比，怀孕期间 COVID-19 患者的 GDM 风险更高 （调整后的风险比 [aRR] = 1.12;95% 置信区间 [CI]，1.08-1.15）。在非西班牙裔白人 （aRR = 1.08;95% CI，1.04-1.14）、非西班牙裔黑人 （aRR = 1.15;95% CI，1.07-1.24） 和西班牙裔 （aRR = 1.17;95% CI，1.10-1.24） 组中，GDM 风险与 COVID-19 显著相关。与奥密克戎 （aRR = 1.07;95% CI，1.02-1.13） 时期相比，德尔塔前期 （aRR = 1.17;95% CI，1.11-1.24） 的 GDM 风险显著更高，但与德尔塔期 （aRR = 1.10;95% CI，1.04-1.17） 没有差异。所有模型的校正风险差为 0%–2%。结论 在基于索赔的数据中，怀孕期间的 COVID-19 与 GDM 呈适度相关，尤其是在早期的 SARS-CoV-2 变异时期。由于这些关联是基于索赔数据中的 COVID-19，因此有必要进行系统测试的研究。