(856) Impact of the COVID-19 Pandemic on Gestational Diabetes Screening Test Performance in WNC

Objective: To assess the impact of the COVID-19 pandemic across 3 parallel, 12-month epochs, pre-pandemic through post vaccine availability, on standard of care gestational diabetes screening.

Study Design: Retrospective cross-sectional study: pre-pandemic (pre-C, Mar-Feb 2019-20) vs first COVID-19 surges (C-T1, 2020-21) vs post vaccine availability (C-T2, 2021-22) in a community-based OB residency clinic in mostly rural western North Carolina. Included patients had no prior DM diagnosis, ongoing care, & were recommended for routine glucose screen [2-hour glucose tolerance test (GTT)] at 24-29 weeks gestation. Analyses utilized chi square (proportions), ANOVA (age), and binary logistic regression to examine associations with “on-time” GTT.

Results: Early screen identified pre-DM in 1.6%, 2.6% and 4% (p=0.031) resulting in 483, 478, and 363 patients recommended GTT. Socio-demographics were consistent across epochs (Table 1). The proportion of patients forgoing GTT was not significantly different (27.3% to 29.7% to 32%, p=0.222). The proportions of “on-time” GTTs (24-29 weeks) increased from pre-C (67.2%) to C-T1 (73.6%) but decreased in C-T2 (58.6%, p=0.001; Table 2). Older patients were more likely to have on-time GTT (OR 1.036; 95%CI 1.007, 1.065). Overall, rates of GDM remained stable across the 3 epochs independent of GTT timing (Table 2).

Conclusion: Consistent with comparisons of shorter duration, the proportion of patients completing third trimester GDM screening remained relatively stable into the pandemic. We found, however, that across 3 12-month epochs from pre-pandemic through post vaccine availability, the proportion screened “on time” was highest during the first year of COVID-19 surges. Improvement in on-time screen during this pre-vaccine epoch may reflect patients taking advantage of limited opportunity for face-to-face prenatal visits. Rates of GDM did not vary. Generalizability is limited by data from 1 site, & additional study is required.