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

J Perinatol. 2018 Apr;38(4):315-323. doi: 10.1038/s41372-017-0035-1. Epub 2018 Jan 3.

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Colorado / epidemiology
  • Counseling / statistics & numerical data*
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes, Gestational / epidemiology*
  • Exercise
  • Female
  • Humans
  • Logistic Models
  • Mass Screening / statistics & numerical data*
  • Massachusetts / epidemiology
  • Multivariate Analysis
  • Nutritional Requirements
  • Population Surveillance
  • Postpartum Period*
  • Pregnancy
  • Prenatal Care / methods
  • Risk Assessment
  • Young Adult