# Impact of Maternal Hyperglycemic and Hypertensive Disorders on Perinatal Outcomes Across the COVID-19 Pandemic

## TL;DR

This study found that maternal hyperglycemic and hypertensive disorders during pregnancy are linked to higher risks of adverse outcomes for mothers and newborns, even during the COVID-19 pandemic.

## Contribution

The study reveals consistent associations between maternal metabolic disorders and adverse perinatal outcomes across different pandemic phases.

## Key findings

- Maternal diabetes and hypertension were linked to higher risks of preterm birth and neonatal complications during the pandemic.
- The associations between maternal disorders and adverse outcomes remained consistent before and during the pandemic.
- Controlling blood sugar and blood pressure is critical to reducing perinatal risks regardless of pandemic conditions.

## Abstract

This study aimed to evaluate the joint associations of maternal hyperglycemic and hypertensive disorders with adverse pregnancy outcomes across the coronavirus disease 2019 (COVID-19) pandemic.

This retrospective study included 110,447 Louisiana Medicaid pregnant women with first-time delivery from January 1, 2016, to December 31, 2021. Associations between hyperglycemic as well as hypertensive disorders and adverse pregnancy outcomes in pregnancy during prepandemic, early pandemic, and late pandemic were assessed by binary logistic regression.

The odds ratios of above adverse pregnancy outcomes were significantly higher during the early and late COVID-19 pandemic than those before the pandemic. Maternal gestational diabetes mellitus and diabetes before pregnancy were associated with higher risks of preterm birth, primary cesarean section, large for gestational age (LGA), macrosomia, neonatal hypoglycemia, neonatal jaundice, and neonatal respiratory distress syndrome (NRDS; all p < 0.05), respectively, compared with women with normal glucose during pregnancy. Maternal gestational hypertension, preeclampsia or eclampsia, and pre-existing hypertension were associated with higher risks of preterm birth, primary cesarean section, low birth weight (exception for gestational hypertension), small for gestational age, LGA (exception for preeclampsia or eclampsia), macrosomia (exception for preeclampsia or eclampsia), neonatal hypoglycemia, neonatal jaundice, and NRDS (all p < 0.05), respectively, compared with women with normal blood pressure during pregnancy. Most of these associations during the early and late pandemic were consistent with those before the COVID-19 pandemic.

Maternal hyperglycemic and hypertensive disorders during pregnancy, compared with maternal normal glucose or blood pressure during pregnancy, were associated with higher risks of adverse maternal and neonatal outcomes. Interventions should be taken to help individuals achieve glycemic and blood pressure control to decrease the risk of adverse perinatal outcomes regardless of the COVID-19 pandemic.