Article | Published:

Prenatal counseling on type 2 diabetes risk, exercise, and nutrition affects the likelihood of postpartum diabetes screening after gestational diabetes

Journal of Perinatologyvolume 38pages315323 (2018) | Download Citation

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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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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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.

Author information

Affiliations

  1. Washington University School of Medicine, St. Louis, MO, USA

    • Kai E. Jones
  2. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA

    • Yan Yan
    • , Graham A. Colditz
    •  & Cynthia J. Herrick
  3. Division of Endocrinology, Metabolism and Lipid Research, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA

    • Cynthia J. Herrick

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Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Cynthia J. Herrick.

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DOI

https://doi.org/10.1038/s41372-017-0035-1