Associations with low rates of postpartum glucose screening after gestational diabetes among Indigenous and non-Indigenous Australian women.
OBJECTIVE
To explore factors associated with postpartum glucose screening among women with Gestational Diabetes Mellitus (GDM).


METHODS
A retrospective study using linked records from women with GDM who gave birth at Cairns Hospital in Far North Queensland, Australia, from 1 January 2004 to 31 December 2010.


RESULTS
The rates of postpartum Oral Glucose Tolerance Test (OGTT) screening, while having increased significantly among both Indigenous* and non-Indigenous women from 2004 to 2010 (HR 1.15 per year, 95%CI 1.08-1.22, p<0.0001), remain low, particularly among Indigenous women (10% versus 27%, respectively at six months postpartum). Indigenous women in Cairns had a longer time to postpartum OGTT than Indigenous women in remote areas (HR 0.58, 0.38-0.71, p=0.01). Non-Indigenous women had a longer time to postpartum OGTT if they: were born in Australia (HR 0.76, 0.59-1.00, 0.05); were aged <25 years (HR 0.45, 0.23-0.89, p=0.02); had parity >5 (HR 0.33, 0.12-0.90, p=0.03); smoked (HR 0.48, 0.31-0.76, p=0.001); and did not breastfeed (HR 0.09, 0.01-0.64, p=0.02).


CONCLUSIONS
Postpartum diabetes screening rates following GDM in Far North Queensland are low, particularly among Indigenous women, with lower rates seen in the regional centre; and among non-Indigenous women with indicators of low socioeconomic status.


CONCLUSIONS
Strategies are urgently needed to improve postpartum diabetes screening after GDM that reach women most at risk.
Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria; Onemda VicHealth Koori Health Unit, School of Population and Global Health, University of Melbourne, Victoria.
Catherine
C
Chamberlain
Bronwyn
B
Fredericks
Anna
A
McLean
Brian
B
Oldenburg
Jacqueline
J
Mein
Rory
R
Wolfe
D000328:Adult; D001315:Australia / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000208:ethnology; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000706:statistics & numerical data* / Q000639:trends; D008875:Middle Aged; D049590:Postpartum Period; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors
D001786:Blood Glucose
Aboriginal; Indigenous; diabetes; gestational diabetes mellitus; pregnancy; type 2 diabetes mellitus