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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. Screening for GDM using RCOG Covid criteria reduced detection rates. Screening for GDM using RCOG Covid criteria reduced detection rates. [ABSTRACT FROM AUTHOR]

Objective: To determine whether screening for gestational diabetes mellitus (GDM) in the third trimester and managing those who are screen positive on a diabetes pathway affects obstetric and neonatal outcomes., Design: Retrospective study of prospectively collected data., Setting: London Teaching Hospital., Population or Sample: A total of 14 366 women delivering between 1 January 2018 and 31 December 2020., Methods: Retrospective chart analysis., Main Outcome Measures: Diagnosis of late-onset GDM, obstetric and neonatal outcomes., Results: Five hundred and thirty-one women were tested by home glucose monitoring for late-onset GDM from 33 weeks of gestation. In all, 244 were diagnosed as having GDM (group 1) and managed accordingly, and 287 (group 2) were returned to normal care. A total of 1415 women had GDM diagnosed by oral glucose tolerance test before 33 weeks of gestation (group 3). Of the women in group 2, 49.5% had a spontaneous onset of labour compared with only 25.8% and 27% in groups 1 and 3. However, women in group 2 were significantly more likely to have a macrosomic baby (≥4000 g, 25.4%) than groups 1 (16.0%) or 3 (7.2%), and their babies were more likely to be admitted to special care (5.2% versus 2% in group 1). Macrosomic babies were associated with significantly higher rates of shoulder dystocia, third- and fourth-degree tears and postpartum haemorrhage., Conclusions: Apparent late-onset GDM affects a significant proportion of women, and targeted intervention was associated with better obstetric and neonatal outcomes. These results suggest that all pregnancies with risk factors for late-onset GDM might benefit from active GDM management irrespective of specific glucose thresholds., Tweetable Abstract: Women with risk factors for GDM in the third trimester, and their babies, would probably benefit from active management of their blood sugars irrespective of threshold values., (© 2022 John Wiley & Sons Ltd.)

Objective: To test the hypothesis that there is seasonal variation in the rates of gestational diabetes (GDM) diagnosed using a 2-hour oral glucose tolerance test., Design: Monthly assessment of the percentage of women screened from 1 April 2016 to the 31 December 2020 who were diagnosed as having gestational diabetes., Setting: London teaching hospital., Population: 28 128 women receiving antenatal care between 1 April 2016 and 31 December 2020., Methods: Retrospective study of prospectively collected data., Main Outcome Measures: Proportion of women screened diagnosed as having gestational diabetes., Results: The mean (SD) percentage of women diagnosed with GDM was 14.78 (2.24) in summer (June, July, August) compared with 11.23 (1.62) in winter (P < 0.001), 12.13 (1.94) in spring (P = 0.002) and 11.88 (2.67) in autumn (P = 0.003). There was a highly significant positive correlation of the percentage testing positive for GDM with the mean maximum monthly temperature (R 2  = 0.248, P < 0.001). There was a statistically significant 33.8% increase in the proportion of GDM diagnoses from June 2020 onwards, possibly related to a reduction in exercise secondary to the Covid-19 pandemic., Conclusions: There is a 23.3% higher rate of GDM diagnoses in the warmer summer months. There has been a 33.8% rise in GDM diagnoses associated with the Covid-19 pandemic., Tweetable Abstract: Rates of GDM are higher in summer and since the onset of the Covid-19 pandemic., (© 2021 John Wiley & Sons Ltd.)