Regarding the secondary outcomes, the adjusted odds for cesarean delivery (aOR 1.33, 95% CI 1.08; 1.64) were higher in women with GDM and SARS-CoV-2 infection as compared with women with GDM before the pandemic, while no differences were observed for LGA, SGA, maternal insulin therapy, and birth weight ≥4500 g (online supplemental table 3). The gene discussed is INS; the disease is gestational diabetes.