Randomization of Early Diabetes Screening Among Obese Pregnant Women (REDSOAP Study)

Objective The study aimed to evaluate perinatal outcomes associated with introduction of and adherence to early diabetes screening guidelines. Study Design Retrospective cohort study of all women who received prenatal care at a single, high-volume tertiary care center before (“preguidelines”) and after (“postguidelines”) American College of Obstetrics and Gynecology guidelines for early pregnancy diabetes screening for women at high risk for diabetes. Women with known pregestational diabetes, late entry to prenatal care, a fetus with a known anomaly, or multiple gestation were excluded. Multivariable linear and logistic regression models were constructed to compare maternal and neonatal outcomes between women in the preguidelines cohort to those in the postguidelines cohort. Similarly, adherence to screening guidelines was assessed, and among all women who were eligible for early diabetes screening, multivariable linear, and logistic models were created to compare outcomes between those women who were screened early to those who were not. Results Of the 2,069 women eligible for analysis, 64.6% (n = 1,337) were in the postguideline cohort. Women in the postguideline cohort were older, less likely to have a history of smoking, and more likely to be non-Hispanic white. On multivariable analysis, women in the postguideline cohort had significantly less gestational weight gain (aβ = −2.3; 95% confidence interval [CI]: −3.4 to −1.1), but a higher odds of 5-minute Apgar's score of <7 (adjusted odds ratio: 2.51; 95% CI: 1.11–5.66). Of 461 women who met ACOG early diabetes screening criteria, 58.7% (n = 270) were screened appropriately. Adherence to screening was associated with parity, race, insurance, and BMI. On multivariable analysis, there were no significant differences in neonatal outcomes between women meeting early screening criteria who were screened early and those who were not. Conclusion Introduction of early diabetes screening guidelines was associated with a significant decrease in gestational weight gain, but did not improve neonatal outcomes. Key Points

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Missed Opportunities for Early Diabetes Screening in Pregnancy

American Journal of Perinatology ◽

10.1055/s-0039-1694727 ◽

2019 ◽

Vol 38 (01) ◽

pp. 023-027

Author(s):

Ashley N. Battarbee ◽

Maximiliano Cavallini ◽

Catherine Keller ◽

Kim A. Boggess

Keyword(s):

At Risk ◽

Early Pregnancy ◽

Best Practice ◽

Challenge Test ◽

Error Variance ◽

Diabetes Screening ◽

Provider Education ◽

Early Screening ◽

Retrospective Case ◽

Early Diabetes

Abstract Objective This study aimed to identify characteristics of women at risk of undiagnosed type 2 diabetes mellitus (T2DM) that fail to receive early pregnancy screening. Study Design This was a retrospective case–control study of at-risk women who initiated care at the University of North Carolina at Chapel Hill at <21 weeks from January 2015 to December 2015. In 2013, the American College of Obstetricians and Gynecologists and the American Diabetes Association recommended women with prior GDM, glucose intolerance, or body mass index (BMI) ≥ 30 kg/m2 receive early pregnancy screening for undiagnosed T2DM. We defined early screening as 1-hour 50-g glucose challenge test or hemoglobin A1c at <21 weeks' gestation. Cases were women who did not have early screening, and controls were women who did. Modified Poisson regression with robust error variance estimated relative risks of factors associated with missed early screening. Results Of the 1,932 women who initiated care at <21 weeks, 257 (13%) women were at risk of undiagnosed T2DM and, thus, candidates for early screening. However, 129 (50.2%) women were not screened. Higher BMI and prior GDM were associated with a lower relative risk of missed screening. Conclusion Higher BMI and prior GDM increased the likelihood of early diabetes screening, but only half of at-risk women were screened. Provider education and best practice alert systems are needed to increase screening for undiagnosed T2DM.

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295: Early diabetes screening in obese women

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2015.10.334 ◽

2016 ◽

Vol 214 (1) ◽

pp. S169

Author(s):

Samadh F. Ravangard ◽

Ashley Scott ◽

Dimitrios Mastrogiannis ◽

Michelle A. Kominiarek

Keyword(s):

Obese Women ◽

Diabetes Screening ◽

Early Diabetes

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Early diabetes screening in women with previous gestational diabetes: a new insight

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-016-0172-2 ◽

2016 ◽

Vol 8 (1) ◽

Cited By ~ 2

Author(s):

Aline Nabuco ◽

Samara Pimentel ◽

Carolina A. Cabizuca ◽

Melanie Rodacki ◽

Denise Finamore ◽

...

Keyword(s):

Gestational Diabetes ◽

Diabetes Screening ◽

Early Diabetes ◽

Previous Gestational Diabetes

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GESTATIONAL DIABETES; SCREENING IN PREGNANT WOMEN

The Professional Medical Journal ◽

10.17957/tpmj/16.3425 ◽

2016 ◽

Vol 23 (12) ◽

pp. 1465-1470

Author(s):

Dr. Ashba Anwer ◽

Dr. Uzma Asif ◽

Dr. Muhammad Asif Bhalli ◽

Midhat Asif

Keyword(s):

Gestational Diabetes ◽

Pregnant Women ◽

Diabetes Screening

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589: Evaluation of adherence to early diabetes screening during pregnancy

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2019.11.605 ◽

2020 ◽

Vol 222 (1) ◽

pp. S378

Author(s):

Nevert Badreldin ◽

Rebecca Weiss ◽

Kathleen Drexler ◽

Lynn M. Yee

Keyword(s):

Diabetes Screening ◽

Early Diabetes

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Preferences of participating in diabetes screening programs for postpartum women with gestational diabetes mellitus in a university hospital in Turkey

Journal of Health Research ◽

10.1108/jhr-08-2020-0372 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Azime Karakoc Kumsar ◽

Feride Taskin Yilmaz ◽

Gulbahtiyar Demirel

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Postpartum Period ◽

University Hospital ◽

Individual Identification ◽

Diabetes Screening ◽

Content Type ◽

History Of

PurposeThe aim of this study is to determine the preferences to participate in diabetes screening program of women with gestational diabetes mellitus (GDM) in postpartum period.Design/methodology/approachThe data of retrospective and descriptive study were collected using “Individual Identification Form” and “Information Form for the Screening of Diabetes in the Postpartum Period” from 151 women in referred to obstetrics and gynecology clinic of a university hospital in Turkey.FindingsOnly 21.9% of women had diabetes screening in postpartum period and 21.2% of the participants were diagnosed with type 2 diabetes. It was determined that the participants mostly participated in screening because of the diabetes history in their family (30.3%). Women who had diabetes screening in postpartum period had lower level of education than those who did not and their level of knowledge about the screening in postpartum and the history of abortion were higher (p < 0.01).Originality/valueThe rate of participation in the screening for diabetes in the postpartum period is very low in pregnant women diagnosed with GDM. It was determined that the educational status, history of previous abortion and knowledge level of the women were factors that prevented participation in diabetes screening. This research is original because there are inadequacy of studies examining determining the participation status of pregnant women with GDM to diabetes screening in the literature. This study will contribute to health professionals in order to improve preventive factors and increase the participation of pregnant women with GDM in diabetes screening in the postpartum period.

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Behaviors of Turkish pregnant women towards gestational diabetes screening

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.5.4176 ◽

2021 ◽

Vol 37 (5) ◽

Author(s):

Hüseyin Aydoğmuş ◽

Serpil Aydoğmuş ◽

Halil Ibrahim Tıraş ◽

Zeynep Cankaya

Keyword(s):

Gestational Diabetes ◽

Pregnant Women ◽

Perinatal Death ◽

Gestational Hypertension ◽

Fetal Distress ◽

Control Group ◽

Oral Glucose ◽

Diabetes Screening ◽

Maternal Complications ◽

Gynecology And Obstetrics

Objectives: Although gestational diabetes is the most common metabolic disease in pregnancy some pregnant women still refuse to undergo oral glucose tolerance test (OGTT). The purpose of this study was to evaluate the behavior of pregnant women undergoing OGTT, and to compare perinatal results between women who undergo and refuse OGTT. Methods: This retrospective cohort study was performed by evaluating the data of Izmir Katip Celebi University Gynecology and Obstetrics outpatient clinic between 2012-2017. Data of 2079 pregnant were evaluated retrospectively. Among 373 women who refused OGTT were evaluated as the study group, while remaining 1706 women who underwent OGTT were considered as the control group. The groups were compared with regard to perinatal results. Results: Sixty-two point four percent of the group who refused OGTT had a C-section, while 56.3% of the control group had a C-section (p<0.05). Intrauterine growth retardation, fetal distress, amniotic fluid pathologies, macrosomia, gestational hypertension and perinatal death were slightly higher in pregnant women who did not undergo OGTT compared to the control group, however, the difference was not statistically significant. Conclusion: Maternal complications and poor pregnancy results were found slightly higher in pregnant women who refused OGTT. These results might be explained by assuring glycemic control in pregnant women who refused OGTT by a series of fasting and postprandial blood sugar measurements in our center. doi: https://doi.org/10.12669/pjms.37.5.4176 How to cite this:Aydogmus H, Aydogmus S, Tiras HI, Cankaya Z . Behaviors of Turkish pregnant women towards gestational diabetes screening. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4176 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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