Associations with low rates of postpartum glucose screening after gestational diabetes among Indigenous and non‐Indigenous Australian women

Abstract

ObjectivesTo explore factors associated with postpartum glucose screening among women with Gestational Diabetes Mellitus (GDM). MethodsA 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. ResultsThe rates of postpartum Oral Glucose Tolerance Test (OGTT) screening, while having increased significantly among both Indigenous**The term ‘Indigenous’ is used when referring to Aboriginal and Torres Strait Islander peoples in Australia collectively, and Indigenous peoples in other countries. This is for ease of reading in this paper only, and we respectfully acknowledge the diversity and autonomy of different communities included in this broad term. 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). ConclusionsPostpartum 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. ImplicationsStrategies are urgently needed to improve postpartum diabetes screening after GDM that reach women most at risk.