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Pregnancy, Gestational Diabetes, and COVID-19

Mothers-to-be, especially those with gestational diabetes, want to be aware of how COVID-19 can affect pregnancy. Here are the potential risks—as well as the good news.

There are core differences between diabetes and gestational diabetes.

As the novel Coronavirus, or COVID-19, makes its way across the globe, there’s no doubt that you’re likely feeling extra anxiety during your pregnancy. You may be asking yourself how COVID-19 affects pregnant people — and how it affects people with gestational diabetes, specifically. If so, you’re not alone in your concerns. 

Being pregnant, you already have a lot on your plate — like your health, your growing baby, and your future plans with baby and family.

What we know about how the Coronavirus affects pregnant people and people with gestational diabetes

Whether you have gestational diabetes yourself, or you’re a caregiver for or a family member of someone with gestational diabetes, you should understand the condition and how COVID-19 might affect it. 

First things first: Gestational diabetes, which occurs in about 18 percent of pregnancies, is a condition marked by high blood sugar during pregnancy (it’s usually tested for around 26 weeks), although there are often no specific or obvious symptoms. The elevated levels are caused by hormones released by the placenta in pregnancy. This condition can sometimes — but not always — cause delivery issues, health problems for your baby, or type 2 diabetes in the mother, unless the mother already has diabetes going into pregnancy.

There are core differences between diabetes and gestational diabetes, though. “Gestational diabetes is not like chronic diabetes,” according to Daniel Roshan, MD, assistant professor, NYU School of Medicine, and director, ROSH Maternal-Fetal Medicine, “as these patients only get diabetes during pregnancy and often recover post-pregnancy, so there isn't any underlying vascular, heart, or renal issues.”

So how does COVID-19 come into play? According to Sherry Ross, MD, OBGYN, pregnant women are not necessarily more likely to get Coronavirus, but being pregnant in general means your immune system is more compromised. Having gestational diabetes adds yet another layer to the matter, Ross explains, although gestational diabetes presents a generally lower risk than having diabetes coming into pregnancy.

Pregnant women may be more susceptible to the Coronavirus, while gestational diabetes may make symptoms more severe

According to the CDC, “Pregnant women experience immunologic and physiologic changes which might make them more susceptible to viral respiratory infections, including COVID-19.”

As is the case with other respiratory illnesses and coronaviruses, such as severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), pregnancy may increase the risk of severe illness, morbidity, or mortality. 

Sadly, there have been cases of pregnancy loss, miscarriage, and stillbirth in women with SARS-CoV and MERS-CoV during pregnancy, but there are no studies yet of COVID-19. It’s important to note that high fevers (one of the symptoms of COVID-19) during the first trimester can cause or increase the risk of birth defects. 

Babies can be born with COVID-19, however. In a March 26, 2020 research letter published in JAMA Pediatrics, researchers wrote, “Although two recent studies have shown that there were no clinical findings or investigations suggestive of COVID-19 in neonates born to affected mothers, and all samples, including amniotic fluid, cord blood, and breast milk, were negative for SARS-CoV-2, the vertical maternal-fetal transmission cannot be ruled out in the current cohort.” The letter focused on three babies who were born with Coronavirus. They all survived. 

What to do if youre pregnant and having COVID-19 symptoms

If you are pregnant and you do get sick with a cold or suspect you’ve contracted Coronavirus and want to seek medical help, it might worry you to think about going into a medical facility, where germs are abundant. In that case, it’s best to call your medical provider or request a telemedicine appointment with your PCP or OBGYN. As per the CDC guidelines, call 911 if you are experiencing a diabetic emergency or have a high fever, shortness of breath, or confusion.  

If you’re not sick, you should still engage in preventive measures to avoid getting sick or passing COVID-19 to someone else (you may be asymptomatic). Wash your hands often, practice social distancing, and disinfect your home often. 

And while some worry is to be expected, try not to fall down an anxiety rabbit hole. Dr. Roshan says, “All pregnant patients, while they should be extra careful, should not panic if they get it — and follow their doctor’s advice.”

A positive outlook for mothers-to-be managing gestational diabetes during COVID-19

According to Dr. Roshan, things look positive for pregnant women with gestational diabetes during the COVID-19 pandemic. “If patients keep their glucose values within normal range, they should be at the same risk as other pregnant or non-pregnant patients,” he says. 

First up, you’ll want to make sure you have access to insulin, along with any other medication—especially if you’re in quarantine. That means staying ahead of your prescription, recommends Dr. Ross. Not every woman with gestational diabetes will need medication, though.

Beyond taking any medication you might need, Dr. Ross says you should be focused on sleeping and exercising, both of which can help support healthy glucose levels. If that means doing a YouTube workout in your living room a few times a week or getting into bed (with a good book!) earlier than normal, do it. 

Food is your friend, as well. Dr. Roshan says you’ll want to keep a low-carbohydrate diet while keeping your glucose values in range. Because you’re stuck in quarantine, you’ll want to make sure you have access to healthy, veggie-based groceries. You might consider ordering a healthy food subscription box or only making trips out for healthy foods. Controlling your blood sugar means preventing pregnancy complications. Plus, healthy foods will support your immune health as well — a must in times of pandemic.

Manage stress to keep cortisol levels in check

Dr. Ross also emphasizes the impact on stress (reading the news too often?) and the pregnant mother-to-be. During a global pandemic, it’s only natural to feel worried, sad, anxious, or scared. In fact, it’s healthy to be upfront and in-touch with your emotions. However, you’ve got to manage your stress levels so they don’t affect you physically. 

“Stress affects our blood pressure, pulse, hormones, and every aspect of our well-being — and it can affect sugar levels,” Dr. Ross says, suggesting women with gestational diabetes turn to a yoga, mindfulness, or breathing regimen. A therapist might also be beneficial, especially at this time. It’s wise to make sure your OBGYN offers a telemedicine option so you can get help and support when you need it.

Try not to spend too much of your time stressing out. Focus on exercising, eating well, and social distancing. While this situation is scary for everyone, the numbers are reassuring.

“It’s really a hard time for the whole world,” Dr. Roshan says. “The good news is that among healthy and young patients, 98 percent will recover without any consequences.”

 

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