Adherence to postpartum diabetes mellitus screening, do associated pregnancy complications make a difference?

Rotem, Reut; Salem-Yaniv, Simrit; Sandler-Rahat, Hadar; Yohay, David; Sade, Shanny; Yahav, Lior; Weintraub, Adi Y.

doi:10.1016/j.diabres.2019.107972

Cited by 5 publications

(9 citation statements)

References 15 publications

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“…A possible explanation for this nding is that a more distressing delivery may increase the likelihood for better postpartum follow-up. This nding is in opposed to previous study which compared screening rates of women with and without GDM associated complications, and did not nd a difference in screening rates between the two groups (19). On the other hand, caesarean section was not found to be signi cantly associated with increasing postpartum DM screening.…”

Section: Discussioncontrasting

confidence: 99%

“…In these studies older age, nulliparity, Asian origin, insulin treatment during pregnancy and attending a post-partum follow up visit were found to be associated with completing the postpartum DM screening (5,(14)(15)(16)(17)(18). Another study evaluated whether GDM associated complications changed the rate of compliance with postpartum DM screening recommendations and found no signi cant difference (19).…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with compliance to the recommendations for postpartum diabetes mellitus screening among women with gestational diabetes mellitus

Yahav

Salem

Sandler-Rahat

et al. 2022

Arch Gynecol Obstet

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Objective: Since women with GDM have an increased risk to develop type 2 DM, a 75g OGTT is recommended 6-12 weeks postpartum for all women with GDM. However, screening rates remain low. The aim of this study was to nd factors affect the rate of postpartum DM screening.Materials and methods: A retrospective cohort study between 2016 and 2017 at the Soroka Medical Center, comparing women with GDM who underwent postpartum DM screening test to those who didn't.Results: 257 women who had a diagnosis of GDM and met the inclusion criteria were included. 53 (20.6%) had a postpartum DM screening test and 204 (79.4%) did not complete the postpartum DM screening.Women who underwent a DM screening postpartum were more likely to be older, with signi cantly higher rates of vacuum assisted delivery, more likely to be diagnosed with GDMA2 as compared to GDMA1 during pregnancy and, with high probability of receiving recommendations for screening at a postpartum visit.Conclusions: The rates of postpartum DM screening for women with GDM are low and need to increase. Age greater than 25, vacuum delivery, GDMA2 and having received a recommendation for postpartum screening increased the likelihood of undergoing a postpartum DM screening. SynopsisAge greater than 25, vacuum delivery, GDMA2 and having received a recommendation for postpartum screening increased the likelihood of undergoing a postpartum DM screening

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors associated with compliance to the recommendations for postpartum diabetes mellitus screening among women with gestational diabetes mellitus

Yahav

Salem

Sandler-Rahat

et al. 2022

Arch Gynecol Obstet

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“…[8][9][10] However, despite the recommendations, the rate of patients diagnosed with GDM who undergo postpartum screening is generally low, ranging from 19.5% to 54%. 11,12 adherent to the puerperal screening. We need strategies to increase the rate of performance of this exam.…”

Section: Introductionmentioning

confidence: 99%

“… 8 9 10 However, despite the recommendations, the rate of patients diagnosed with GDM who undergo postpartum screening is generally low, ranging from 19.5% to 54%. 11 12 …”

Section: Introductionmentioning

confidence: 99%

Prevalence of Screening for Diabetes Mellitus in Patients Previously Diagnosed with Gestational Diabetes: Factors Related to its Performance

Kindermann

Costa

Trapani

2022

Rev Bras Ginecol Obstet

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Objective To determine how many patients underwent screening for diabetes mellitus (DM) in the puerperium after a diagnosis of gestational DM (GDM) and which factors were related to its performance. Methods The present is a prospective cohort study with 175 women with a diagnosis of GDM. Sociodemographic and clinico-obstetric data were collected through a questionnaire and a screening test for DM was requested six weeks postpartum. After ten weeks, the researchers contacted the patients by telephone with questions about the performance of the screening. The categorical variables were expressed as absolute and relative frequencies. The measure of association was the relative risk with a 95% confidence interval (95%CI), and values of p ≤ 0.05 were considered statistically significant and tested through logistic regression. Results The survey was completed by 159 patients, 32 (20.1%) of whom underwent puerperal screening. The mean age of the sample was of 30.7 years, and most patients were white (57.9%), married (56.6%), and had had 8 or more years of schooling (72.3%). About 22.6% of the patients used medications to treat GDM, 30.8% had other comorbidities, and 76.7% attended the postnatal appointment. Attendance at the postpartum appointment, the use of medication, and the presence of comorbidities showed an association with the performance of the oral glucose tolerance test in the puerperium. Conclusion The prevalence of screening for DM six weeks postpartum is low in women previously diagnosed with GDM. Patients who attended the postpartum consultation, used medications to treat GDM, and had comorbidities were the most adherent to the puerperal screening. We need strategies to increase the rate of performance of this exam.

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“…9 Provider adherence to postpartum glucose tolerance screening recommendations ranges from 20% to 42% for obstetrics-gynecology attendings, 10,11 43% for obstetrics-gynecology resident physicians, 12 and 58% for maternal-fetal medicine specialists. 11 Interventions for increasing provider adherence to postpartum glucose tolerance testing recommendations focus on educating the provider about the importance of postpartum glucose tolerance testing 13 or the use of written reminders to the physician. 14 Patient attendance at the postpartum follow-up appointment is necessary to perform postpartum glucose tolerance screening.…”

mentioning

confidence: 99%

Implementation of a Postpartum Note Reminder and Factors Associated with Postpartum Glucose Tolerance Screening

Domingo¹,

Fogel²,

Raffel³

et al. 2022

Southern Medical Journal

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Objectives: Although reminder systems are used to increase provider adherence, we are not aware of any real-time reminder systems for provider adherence to postpartum glucose tolerance testing. We studied whether a reminder in the electronic medical records affects provider ordering of a postpartum glucose tolerance test. We also studied whether any demographic, medical history, prenatal, or delivery variables are associated with patient attendance to a postpartum visit and patient completion of the postpartum glucose tolerance test when ordered.Methods: This was a retrospective study of 246 women diagnosed as having gestational diabetes mellitus who completed prenatal care and delivered at a suburban public safety-net hospital.Results: Implementation of the real-time postpartum note reminder system significantly improved provider adherence to postpartum glucose screening recommendations from 58.1% to 75.0% ( P = 0.01). Delivery complications were significantly associated with increased odds for postpartum visit attendance (odds ratio [OR] 3.80, 95% confidence interval [CI] 1.63-8.86, P < 0.01). Increased gestational age at first prenatal visit was significantly associated with decreased odds for postpartum visit attendance (OR 0.93, 95% CI 0.87-0.99, P < 0.05). Speaking Spanish was associated with an increased odds for completion of the postpartum glucose tolerance test when ordered (OR 2.88, 95% CI 1.24-6.70, P = 0.01). Conclusions:We recommend that hospital managers include a reminder system in the electronic medical record. Providers should focus counseling on the potential future risks to the mother, in addition to encouraging continued adherence to postpartum care. Providers also should counsel those who present later to prenatal care about the importance of obtaining postpartum glucose tolerance tests.

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Adherence to postpartum diabetes mellitus screening, do associated pregnancy complications make a difference?

Cited by 5 publications

References 15 publications

Factors associated with compliance to the recommendations for postpartum diabetes mellitus screening among women with gestational diabetes mellitus

Factors associated with compliance to the recommendations for postpartum diabetes mellitus screening among women with gestational diabetes mellitus

Prevalence of Screening for Diabetes Mellitus in Patients Previously Diagnosed with Gestational Diabetes: Factors Related to its Performance

Implementation of a Postpartum Note Reminder and Factors Associated with Postpartum Glucose Tolerance Screening

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