Abstract
Objective
Screening rates for type 2 diabetes after a pregnancy with gestational diabetes are inadequate. We aimed to determine how prenatal counseling on exercise, nutrition, and type 2 diabetes risk affects postpartum screening for diabetes.
Methods
Using Pregnancy Risk Assessment Monitoring System data from Colorado (2009–2011) and Massachusetts (2012–2013), we performed multivariable logistic regression to examine the relationship between prenatal counseling and postpartum screening.
Results
Among 556 women, prenatal counseling was associated with increased postpartum diabetes screening, after adjusting for age; parity; and receipt of Women, Infants, and Children (WIC) benefits (adjusted odds ratio (AOR) 3.0 [95% CI 1.4–6.5]). This effect was modified by race/ethnicity. Primiparity (AOR 2.2 [95% CI 1.2–4.1]) and advanced maternal age (AOR 2.2 [95% CI 1.2–3.8]) were associated with increased screening, and receiving WIC benefits was associated with decreased screening (AOR 0.5 [95% CI 0.3–0.9]).
Conclusions
In women with gestational diabetes, culturally appropriate counseling on future diabetes risk, nutrition, and exercise may enhance postpartum diabetes screening.
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Acknowledgements
We would like to acknowledge the PRAMS Working Group at the Centers for Disease Control and Prevention for collection of the primary data, preparation of the dataset, and review of the manuscript.
Funding
KEJ received funding from the National Institutes of Diabetes and Digestive, and Kidney Diseases (5T35DK074375). YY has no support to report. GAC is supported by the Washington University Institute of Clinical and Translational Sciences grant UL1TR000448. CJH received funding from the National Institutes of Diabetes and Digestive and Kidney Diseases pilot grant from the Center for Diabetes Translation Research (1P30DK092950) and the Washington University Institute of Clinical and Translational Sciences grant UL1TR000448, sub award KL2TR000450. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Author contributions
KEJ participated in the study conception, design, analysis, and manuscript preparation. YY participated in the study design and analysis and reviewed the manuscript. GAC provided support in the analysis phase and edited the manuscript. CJH provided content expertise and led the study conception, design, analysis, and manuscript preparation. CJH takes full responsibility for the content of this article.
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The authors declare that they have no conflict of interest.
Additional information
Previous data presentation: The abstract for this study was presented as a poster at the 77th Scientific Sessions of the American Diabetes Association, June 9–13, 2017.
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Jones, K.E., Yan, Y., Colditz, G.A. et al. Prenatal counseling on type 2 diabetes risk, exercise, and nutrition affects the likelihood of postpartum diabetes screening after gestational diabetes. J Perinatol 38, 315–323 (2018). https://doi.org/10.1038/s41372-017-0035-1
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DOI: https://doi.org/10.1038/s41372-017-0035-1