Abstract
Objective This study aims to examine factors associated with postpartum follow-up and glucose
tolerance testing (GTT) in women with gestational diabetes mellitus (GDM).
Materials and Methods Case-control study of women with GDM at a single institution with available outpatient
records (January 2008–February 2016). Women with pregestational diabetes mellitus
were excluded. The postpartum follow-up, GTT completion, and the reason for GTT completion
failure (provider vs. patient noncompliance) were assessed. Bivariable and multivariable
analyses were performed to identify factors associated with postpartum follow-up and
GTT completion.
Results Of 683 women, 82.0% (n = 560) returned postpartum, and 49.8% (n = 279) of those completed GTT. Women with Medicaid and late presentation to care
were less likely to return (adjusted odds ratio [aOR]: 0.3, 95% confidence interval
[CI]: 0.2–0.6 and aOR: 0.4, 95% CI: 0.2–0.7), but if they did, both factors were associated
with increased odds of GTT completion (aOR: 2.0, 95% CI: 1.3–2.9 and aOR: 3.5, 95%
CI: 1.8–6.6). Patient and provider noncompliance contributed equally to GTT completion
failure. Trainee involvement was associated with improved test completion (aOR: 4.6,
95% CI: 2.4–8.8).
Conclusion The majority of women with GDM returned postpartum, but many did not receive recommended
GTT. Public insurance and late presentation were associated with failure to return
postpartum, but better GTT completion when a postpartum visit occurred. Trainee involvement
was associated with improved adherence to screening guidelines.
Keywords
gestational diabetes mellitus - glucose tolerance test - postpartum
