Abstract:
Aims: To identify and document factors associated with screening for gestational diabetes mellitus (GDM) in a region of New Zealand with a predominantly indigenous population. Methods: An audit was undertaken of routine hospital data collected from 656 women who gave birth over two six-month periods (July to December in 2013 and 2014) in two small rural hospitals in New Zealand. Results: Of the 656 women who gave birth during this period, only 416 (63%) were screened for GDM. After controlling for age, screening was less common in Maori women (56%) and in Pacific women (50%) when compared with European women. After adjusting for ethnicity, women aged 35-40 years were more likely to be screened compared with women aged 25-29 years (1.24, 95% CI 1.06-1.47, p=0.02). Screening was associated with longer hospital stays following birth, with screened women more likely to stay =5 days compared with unscreened women <1 day, (1.44, 95% CI 1.25-1.66, p<0.0001). Screening was significantly higher in 2014 than 2013 (1.17 95% CI 1.04-1.32, p=0.008). Conclusion: A hospital-based maternity clinic initiative in 2014 may explain the improvement in screening in that year. However, increased effort is required to improve screening rates, especially for Maori and Pacific women who are at higher risk of developing gestational diabetes mellitus. A longer hospital stay for women screened may indicate a higher risk of pregnancy-related complications and increased contact with maternity services. Further research is needed to help identify reasons for low screening rates in this population.
