Impact of changes to national UK Guidance on testing for gestational diabetes screening during a pandemic: a single-centre observational study

Abstract

Objective: To examine the differences in detection rate for gestational diabetes (GDM) comparing the methodology recommended by the National Institute for Health and Clinical Excellence (NICE) compared with testing described as appropriate during the Covid-19 pandemic by the Royal College of Obstetricians and Gynaecologists (RCOG).

Design: Cohort study of women delivering between 1 January 2016 and 1 July 2020.

Setting: London Teaching Hospital.

Population: All women delivering between 1 January 2016 and 13 May 2020 and follow up of women screening negative between 1 April 2020 and 13 May 2020.

Methods: Retrospective study of prospectively collected data.

Main outcome measures: Detection rate of gestational diabetes.

Results: Using the RCOG guidance, the overall rate of women identified as having gestational diabetes fell from 7.7% (1853/24168) to 4.2% (35/831)(P = 0.0003). Of 230 women who tested negative according to the RCOG criteria from 1 April to 13 May but who subsequently had an oral glucose tolerance test, 47 (20.4%) were diagnosed as having gestational diabetes according to the NICE criteria.

Conclusions: In our setting, the RCOG Covid-19 gestational diabetes screening regime failed to detect 47 of 82 (57%) women subsequently identified as gestational diabetics, and therefore cannot be recommended for general use.

Tweetable abstract: Screening for GDM using RCOG Covid criteria reduced detection rates.

Keywords: Covid-19; gestational diabetes; screen.