Impact of the Creation of a Specialized Clinic for Prenatal Blood Sampling and Follow-up Care in Pregnant Women

Abstract

ObjectiveTo evaluate (1) the effect on gestational diabetes mellitus (GDM) screening rates of having a specialized clinic for pregnant women offering blood sampling and screening for GDM, and (2) the impact on perinatal outcomes of having early GDM screening and follow-up provided by the specialized clinic. MethodsWe performed a retrospective cohort study, based on electronic health records. We compared data from women who delivered during a period when the Blood Sampling in Pregnancy (BSP) clinic was operating (2008–2009; n=2780) to a time period before the clinic was established (2006–2007; n=2591). During the 2008–2009 period, we compared data from women who had GDM screening in the first trimester with women who had screening during the second trimester and with women who were not screened. ResultsFollowing the creation of the BSP clinic, overall GDM screening rates reached 72.4% in 2008–2009, compared with 48.9% in 2006-2007 (P<0.001) and GDM screening was more likely to be performed in the first trimester (36.7% vs. 0.4%; P<0.001). During the period when the BSP clinic was operating (2008-2009), women who had GDM screening in the first trimester had lower rates of Caesarean section (15.7% vs. 22.1 %; P<0.001) and neonatal complications (bradycardia: 3.6% vs. 6.8%; P=0.003; respiratory distress: 9 6% vs 13 2%; P=0 02; and admission to NICU: 15.4% vs. 26.8%; P<0.001) than women who did not perform GDM screening. ConclusionIn our population, creation of a clinic offering specialized care to pregnant women improved GDM screening rates. With the support of the BSP clinic, women who had early GDM screening were less likely to undergo Caesarean section and their offspring had fewer perinatal complications.