Factors influencing postpartum blood glucose screening among women with prior gestational diabetes mellitus in a rural community

Abstract

Aims:The aims of the present study were: a) to investigate the current state of postpartum glucose screening in rural China; and b) to explore the factors influencing postpartum blood glucose screening among women with prior GDM based on Andersen's behavioural model of health service use. Design:A multisite, cross-sectional study design, conducted from November 2017 to January 2018.Methods: A total of 465 women with prior GDM were included from two countylevel hospitals in rural China. The potential influencing factors for postpartum blood glucose screening based on Andersen's behavioural model, including predisposing, enabling, and need factors, were collected by self-reported questionnaires. Chisquare tests and logistic regression were used to explore the influence of these factors on whether screening of blood glucose level after delivery occurred. Results:The mean age of the women was 31.92 years old (SD 5.16) and the mean time after delivery was 16.73 months (SD 15.07). The postpartum glucose screening proportion was 32.7%. Women who did not have a full-time job (p= .011) (predisposing factor), had not received any treatment for GDM (p= .002), and were not informed about screening plans for diabetes by health professionals (p < .001) (enabling factor) were less likely to engage in postpartum glucose screening. The need factor, high actual risk of developing type 2 diabetes mellitus (T2DM), was not associated with postpartum blood glucose screening (p> .05). Conclusions:In rural China, most women with prior GDM were not screened for T2DM after delivery. The women with prior GDM who did not have a full-time job or had not received any prior treatment for GDM should be the target population for health education on postpartum glucose screening.Impact: There is a need for data on postpartum blood glucose testing rates among rural women. Future interventions aimed at increasing postpartum blood glucose screening are needed.

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

“…This index is similar to that found by Ortiz et al, 15 who found a rate of 19%. The prevalence of DM screening in patients with a history of GDM is quite variable in the literature, ranging from 13.8% to 41%, but what all the studies 13,14,[16][17][18][19] show, including the current study, is that even though screening is indicated for all postpartum women with a history of GDM, its performance is still low. Screening is important, as it enables the establishment of the risks of developing DM, so physicians can prescribe behavioral or even pharmacological changes to prevent or delay the its diagnosis in this population and avoid the impacts of this comorbidity in the long term.…”

“…The sampling was carried out by convenience, with an estimated sample size of 175 cases. The calculation was performed with the OpenEpi software, version 3, considering the significant variables from previous studies, 13 14 with bilateral significance (1-α) of 0.05 and power (1-β) of 0.80, and an estimated loss of up to 30%.…”