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Mendez Y, Alpuing Radilla LA, Delgadillo Chabolla LE, Castillo Cruz A, Luna J, Surani S. Gestational diabetes mellitus and COVID-19: The epidemic during the pandemic. World J Diabetes 2023; 14:1178-1193. [PMID: 37664480 PMCID: PMC10473953 DOI: 10.4239/wjd.v14.i8.1178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/24/2023] [Accepted: 07/17/2023] [Indexed: 08/11/2023] Open
Abstract
During the global coronavirus disease 2019 (COVID-19) pandemic, people worldwide have experienced an unprecedented rise in psychological distress and anxiety. In addition to this challenging situation, the prevalence of diabetes mellitus (DM), a hidden epidemic, has been steadily increasing in recent years. Lower-middle-income countries have faced significant barriers in providing accessible prenatal care and promoting a healthy diet for pregnant women, and the pandemic has made these challenges even more difficult to overcome. Pregnant women are at a higher risk of developing complications such as hyper-tension, preeclampsia, and gestational diabetes, all of which can have adverse implications for both maternal and fetal health. The occurrence of gestational diabetes has been on the rise, and it is possible that the pandemic has worsened its prevalence. Although data is limited, studies conducted in Italy and Canada suggest that the pandemic has had an impact on gestational diabetes rates, especially among women in their first trimester of pregnancy. The significant disruptions to daily routines caused by the pandemic, such as limited exercise options, indicate a possible link between COVID-19 and an increased likelihood of experiencing higher levels of weight gain during pregnancy. Notably, individuals in the United States with singleton pregnancies are at a significantly higher risk of excessive gestational weight gain, making this association particularly important to consider. Although comprehensive data is currently lacking, it is important for clinical researchers to explore the possibility of establishing correlations between the stress experienced during the pandemic, its consequences such as gestational gain weight, and the increasing incidence of gestational DM. This knowledge would contribute to better preventive measures and support for pregnant individuals during challenging times.
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Affiliation(s)
- Yamely Mendez
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, United States
| | - Linda A Alpuing Radilla
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, United States
| | | | - Alejandra Castillo Cruz
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, United States
| | - Johanan Luna
- Department of Medicine, Xochicalco University, Mexicali 21376, BC, Mexico
- Department of Medicine, Mt. Olympus Medical Research, Sugarland, TX 77479, United States
| | - Salim Surani
- Department of Medicine & Pharmacology, Texas A&M University, College Station, TX 77843, United States
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Buskmiller C, Greenwood LA, Alpuing Radilla LA, Lane K, Gray LL, Ivey RT, Carrol MR, Munoz JL, Sanz Cortes M, Nassr AA, Belfort MA, Horst K, Donepudi RV. Impact of Transfer of Maternal Care for Fetal Anomalies on Maternal Depression and Anxiety Screening: A Prospective Cohort at a Tertiary Care Center. Fetal Diagn Ther 2023; 50:282-288. [PMID: 37276841 DOI: 10.1159/000531180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 05/16/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Perinatal depression and anxiety are major causes of maternal morbidity, and are more common in high-risk pregnancies compared to low-risk pregnancies. This study used validated screening tools to assess the prevalence of depression and anxiety symptoms in pregnant patients who transferred their obstetric care to a specialized fetal center for fetal anomaly. METHODS This is a prospective cohort of patients with a fetal anomaly prompting transfer of obstetric care to Texas Children's Hospital Fetal Center between January 2021 and February 2022. The primary outcome was a self-assessed Edinburgh Postnatal Depression Scale score of 13 or higher, either antepartum or postpartum ("ever-positive EPDS"). Secondary outcomes included self-assessed Perinatal Anxiety Screening Scale (PASS) scores of 21 or higher ("ever-positive PASS"), obstetric outcomes, and neonatal outcomes. A frequentist analysis was performed. RESULTS Of 149 women who transferred to Texas Children's Hospital during the study period, 94 enrolled in this study. Twenty-six percent of women had an ever-positive EPDS; 20% of patients had an ever-positive PASS. Patients were more likely to have an ever-positive EPDS if they were single (46% compared to 20%, p = 0.025). Women who had an ever-positive EPDS were more likely to be referred to psychiatry (46% compared to 14%, p = 0.004) and psychotherapy (29% compared to 1%, p < 0.001). Surprisingly, patients were more likely to have an ever-positive PASS if they reported good social support (p = 0.03). Antepartum EPDS and PASS scores had no relationship with postpartum EPDS scores. CONCLUSION Women who transfer care to a tertiary setting have positive EPDS scores at double the rate of the general population, but tend to experience this either antepartum or postpartum (not both). Fetal centers should be prepared to screen for mental health symptoms before and after delivery and provide appropriate referral or treatment.
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Affiliation(s)
- Cara Buskmiller
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA
| | - Lauren A Greenwood
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA
| | | | - Keneshia Lane
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA
| | - Lauren L Gray
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA
| | - R Todd Ivey
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA
| | - Matthew R Carrol
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA
| | - Jessian L Munoz
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA
| | | | - Ahmed A Nassr
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA
| | - Michael A Belfort
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA
| | - Karen Horst
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA
| | - Roopali V Donepudi
- Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA
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