Factors Associated with Postpartum Glucose Testing Following Gestational Diabetes Mellitus

Abstract

Objectives: Glucose testing at six weeks after delivery has been recommended by the World Health Organization as the earliest period to detect abnormal glucose tolerance among women with gestational diabetes mellitus (GDM). However, the rate of postpartum glucose testing in many parts of the world is low, between 30–60%. Therefore, we sought to determine the proportion of women with GDM who underwent glucose testing at six weeks postpartum and the factors associated with the compliance to the test. Methods: We conducted a cross-sectional study between January and April 2017 in 13 governmental primary health care clinics in the southern part of Peninsular Malaysia. All eligible postpartum women registered from January to June 2016 who had GDM during their most recent pregnancy were included. Descriptive and multiple logistic regression analyses were performed. Results: Out of 341 women, 35.8% attended primary health care clinics for glucose testing six weeks postpartum. The factors significantly associated with the compliance to postpartum glucose testing were GDM diagnosis in previous pregnancy (adjusted odds ratio (AOR) = 1.76; 95% confidence interval (CI): 1.04–2.99; p =0.036) and normal level of glycated hemoglobin during the most recent pregnancy (AOR = 2.49; 95% CI: 1.06–5.86; p =0.036). Conclusions: The proportion of women with GDM who underwent postpartum glucose testing remained low. Hence, strategies should be reinforced to encourage all women with GDM to undergo postpartum glucose testing.

Keywords

• postpartum period
• glucose tolerance test
• diabetes
• gestational
• primary health care
• malaysia