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Postpartum Diabetes Testing Among Women with Recent Gestational Diabetes Mellitus: PRAMS 2009–2010

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Abstract

The objective of this study was to estimate rates of and factors associated with postpartum diabetes testing in women with recent gestational diabetes mellitus (GDM). Secondary data analysis was conducted using data from the 2009 and 2010 Pregnancy Risk Assessment Monitoring System from three states and one city (Colorado, Minnesota, Utah, and New York City). Frequency of postpartum diabetes testing was estimated overall and among women who attended a postpartum visit. Multivariable logistic regression was used to determine factors associated with postpartum diabetes testing. Approximately 8.2 % [95 % confidence interval (CI) 7.5–8.9] of women self-reported a history of GDM (n = 829), of which 48.5 % (43.9–53.1) reported being tested for diabetes postpartum. Among the 90.0 % (86.5–93.4) of women with recent GDM who attended the postpartum visit, 51.7 % (46.1–57.2) reported being tested for diabetes postpartum. Women who received inadequate/intermediate prenatal care were half as likely to report postpartum testing compared with women who received adequate prenatal care [odds ratio 0.45 (95 % CI 0.25–0.83)]. Women with a prepregnancy body mass index classified as obese were over twice as likely to report postpartum testing compared to normal weight women. Women with GDM are at increased risk of persistent glucose intolerance after delivery, yet postpartum testing rates remain around 50 %, regardless of attendance to the postpartum visit. Improving adequacy of prenatal care might further increase postpartum testing rates. Continued efforts to translate postpartum testing into practice are needed among these women at risk for future type 2 diabetes.

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Abbreviations

GDM:

Gestational diabetes mellitus

PRAMS:

Pregnancy Risk Assessment Monitoring System

CDC:

Centers for Disease Control and Prevention

IOM:

Institute of Medicine

WIC:

The Special Supplemental Nutrition Program for Women, Infants and Children

ADA:

American Diabetes Association

ACOG:

American College of Obstetricians and Gynecologists

NDEP:

National Diabetes Education Program

BMI:

Body mass index

HMO:

Health maintenance organization

FPG:

Fasting plasma glucose

OGTT:

Oral glucose tolerance test

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Acknowledgments

PRAMS Working Group: Alabama—Izza Afgan, MPH; Alaska—Kathy Perham-Hester, MS, MPH; Arkansas—Mary McGehee, PhD; Colorado—Alyson Shupe, PhD; Delaware—George Yocher, MS; Florida—Cynthia Ulysee, MPH; Georgia—Yan Li, MD, MPH; Hawaii—Emily Roberson, MPH; Illinois—Theresa Sandidge, MA; Louisiana—Amy Zapata, MPH; Maine—Tom Patenaude, MPH; Maryland—Diana Cheng, MD; Massachusetts—Emily Lu, MPH; Michigan—Cristin Larder, MS; Minnesota—Judy Punyko, PhD, MPH; Mississippi—Brenda Hughes, MPPA; Missouri—Venkata Garikapaty, MSc, MS, PhD, MPH; Montana—JoAnn Dotson; Nebraska—Brenda Coufal; New Jersey—Lakota Kruse, MD; New Mexico—Eirian Coronado, MPH; New York State—Anne Radigan-Garcia; New York City—Candace Mulready-Ward, MPH; North Carolina—Kathleen Jones-Vessey, MS; North Dakota—Sandra Anseth; Ohio—Connie Geidenberger PhD; Oklahoma—Alicia Lincoln, MSW, MSPH; Oregon—Kenneth Rosenberg, MD, MPH; Pennsylvania—Tony Norwood; Rhode Island—Sam Viner-Brown, PhD; South Carolina—Mike Smith, MSPH; Texas—Rochelle Kingsley, MPH; Tennessee—David Law, PhD; Utah—Laurie Baksh; Vermont—Peggy Brozicevic; Virginia—Marilyn Wenner; Washington—Linda Lohdefinck; West Virginia—Melissa Baker, MA; Wisconsin—Katherine Kvale, PhD; Wyoming—Angi Crotsenberg; CDC PRAMS Team, Applied Sciences Branch, Division of Reproductive Health.

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Authors and Affiliations

  1. Center for Perinatal Research, Research Institute at Nationwide Children’s Hospital, 700 Children’s Drive, Research Building III, Columbus, OH, 43205, USA

    Reena Oza-Frank

  2. Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, 43205, USA

    Reena Oza-Frank

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Correspondence to Reena Oza-Frank.

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Oza-Frank, R. Postpartum Diabetes Testing Among Women with Recent Gestational Diabetes Mellitus: PRAMS 2009–2010. Matern Child Health J 18, 729–736 (2014). https://doi.org/10.1007/s10995-013-1299-5

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