Abstract

PurposeThis study evaluated the extent to which migrant women participate in the mandatory oral glucose tolerance test (OGTT) for gestational diabetes mellitus (GDM) screening in Austria.MethodsA retrospective data analysis was carried out of births at an obstetrics unit in a university hospital between January 2013 and December 2015. The inclusion criteria were singleton pregnancies, live births, birth weight ≥ 3500, and no preexisting diabetes mellitus. The patient’s extramurally obtained OGTT values and history of GDM were checked. If the mother’s country of birth was not Austria, the woman was classified as a migrant. Three groups were defined: group 1—women with normal OGTT; group 2—women with pathological OGTT; and group 3—women without OGTT or with an incomplete OGTT.Main outcome measures: Numbers of complete and incomplete OGTTs and rate of women with pathological OGTTs not treated in accordance with the guidelines among mothers born in Austria or migrants. The groups were compared using the t-test, chi-squared test, or Fisher’s exact test.ResultsA total of 3293 births met the inclusion criteria, and 43.52% of all mothers were migrants; 16.8% of all women had pathological OGTT findings. Only 60.1% of the latter received treatment in accordance with the guidelines. The proportion of mothers born in Austria who did not have OGTTs, or only incomplete ones, was 5.4%. In the group of migrant women, the corresponding figure was 10.5% (P < 0.01).ConclusionsMigrant women have significantly lower rates of participation in GDM screening.

Highlights

  • In recent years, war, terrorism, and natural disasters have led to major waves of migration to Europe

  • The proportion of mothers born in Austria who did not have oral glucose tolerance test (OGTT) or only incomplete testing was 5.4%

  • It is well known from numerous studies that ethnicity has a significant impact on the prevalence of gestational diabetes mellitus (GDM) [14], and this is taken into account in the relevant guidelines [24]

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Summary

Introduction

War, terrorism, and natural disasters have led to major waves of migration to Europe. It has long been known that there is an association between impaired glucose tolerance during pregnancy and increased maternal and fetal morbidity and mortality rates. Neonates of mothers with impaired glucose tolerance experience more clinical neonatal hypoglycemia and more hyperbilirubinemia and hypocalcemia Both the affected women and their children have an increased risk of developing manifest diabetes mellitus [4,5,6]. The rate of impaired glucose tolerance in pregnancy is significantly higher in some migrant populations, leading to increased perinatal complications in comparison with mothers without a migrant background. This applies, in particular, to women from South-East Asia and North Africa [15]. Umbilical artery pH (apH), the 5-min Apgar score and admission to a neonatal care unit were used as fetal outcome parameters

Materials and methods
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Compliance with ethical standards
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