For women with GDM, ADA guidelines urge screening at 4-12 weeks postpartum via OGTT, given its superior sensitivity to detect diabetes. Yet data on screening uptake according to these guidelines is scarce. In a large California integrated health system, we evaluated uptake and predictors of guideline-recommended screening among 2,207 women (77% racial/ethnic minorities) diagnosed with GDM in 2011-2012. Overall screening uptake was 47.9% but varied by race/ethnicity (Figure). In a multivariable adjusted model, black race/ethnicity (odds ratio [OR], [95% CI]: 0.64 [0.44-0.95]) vs. white; having less than a college degree (0.67 [0.56-0.81]) vs. having at least a college degree; parity ≥2 (0.58 [0.45-0.74]) vs. 0; and higher pre-pregnancy BMI (0.97 [0.95-0.98] per unit increase) were associated with lower odds of screening uptake. In the same model, attending a postpartum medical visit (7.96 [4.36-14.5]); Chinese race/ethnicity (2.03 [1.41-2.92]) vs. white; greater years of age (1.04 [1.02-1.06] per unit increase); and greater gestational weeks at delivery (1.06 [1.02-1.10] per unit increase) were associated with higher odds of screening uptake. Postpartum screening uptake varies by patient characteristics in an integrated health system setting. Strategies to reduce barriers, especially among black and non-college educated women, present an opportunity to reduce downstream diabetes health disparities.
S.D. Brown: None. A. Tsai: None. M.M. Hedderson: None. C. Quesenberry: None. A. Ferrara: None.
Kaiser Permanente Northern California
