Improving postpartum screening after diabetes in pregnancy: Results of a pilot study in remote Australia.


Journal

The Australian & New Zealand journal of obstetrics & gynaecology
ISSN: 1479-828X
Titre abrégé: Aust N Z J Obstet Gynaecol
Pays: Australia
ID NLM: 0001027

Informations de publication

Date de publication:
06 2019
Historique:
received: 27 04 2018
accepted: 07 08 2018
pubmed: 3 10 2018
medline: 20 5 2020
entrez: 3 10 2018
Statut: ppublish

Résumé

The postpartum period is a critical time to improve health outcomes for Aboriginal women, particularly for those who have chronic conditions. To assess enhanced support methods (for women following diabetes in pregnancy (DIP)) to improve completion rates of recommended postpartum health checks. Fifty-three Aboriginal women in the Northern Territory (NT) were contacted in the postpartum period to encourage medical check-ups. Messages were delivered through phone (call or text messages) or other methods (Facebook or email). The primary outcome was postpartum blood glucose testing (oral glucose tolerance testing (OGTT), random or fasting glucose and HbA1c). Establishing contact with women was difficult. Of 137 messages sent to 52 women, 22 responded (42%). Phone was the most common contact method with successful contact made from 16 of 119 (13%) attempts. Rates of postpartum OGTT completion were higher in the group successfully contacted (32% vs 7%). However, for any postpartum glucose testing (including OGTT and HbA1c) rates were 25 of 42 (60%) and neither success in making contact nor the contact method was associated with higher rates. The small sample size limits our conclusions; however, results highlight that engaging remote women postpartum is difficult. While rates of postpartum OGTT completion differed according to successful contacts, rates of any postpartum blood glucose testing did not. Further research is needed to explore feasible intervention methods to improve postpartum screening after a pregnancy complicated by diabetes.

Sections du résumé

BACKGROUND
The postpartum period is a critical time to improve health outcomes for Aboriginal women, particularly for those who have chronic conditions.
AIMS
To assess enhanced support methods (for women following diabetes in pregnancy (DIP)) to improve completion rates of recommended postpartum health checks.
MATERIALS AND METHODS
Fifty-three Aboriginal women in the Northern Territory (NT) were contacted in the postpartum period to encourage medical check-ups. Messages were delivered through phone (call or text messages) or other methods (Facebook or email). The primary outcome was postpartum blood glucose testing (oral glucose tolerance testing (OGTT), random or fasting glucose and HbA1c).
RESULTS
Establishing contact with women was difficult. Of 137 messages sent to 52 women, 22 responded (42%). Phone was the most common contact method with successful contact made from 16 of 119 (13%) attempts. Rates of postpartum OGTT completion were higher in the group successfully contacted (32% vs 7%). However, for any postpartum glucose testing (including OGTT and HbA1c) rates were 25 of 42 (60%) and neither success in making contact nor the contact method was associated with higher rates.
CONCLUSIONS
The small sample size limits our conclusions; however, results highlight that engaging remote women postpartum is difficult. While rates of postpartum OGTT completion differed according to successful contacts, rates of any postpartum blood glucose testing did not. Further research is needed to explore feasible intervention methods to improve postpartum screening after a pregnancy complicated by diabetes.

Identifiants

pubmed: 30276799
doi: 10.1111/ajo.12894
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

430-435

Subventions

Organisme : National Health and Medical Research Council
ID : 1092968
Pays : International
Organisme : National Health and Medical Research Council
ID : 1078477
Pays : International
Organisme : National Health and Medical Research Council
ID : 1079438
Pays : International

Informations de copyright

© 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Auteurs

Renae Kirkham (R)

Menzies School of Health Research, Darwin, Australia.

Diana MacKay (D)

Royal Darwin Hospital, Darwin, Australia.

Federica Barzi (F)

Menzies School of Health Research, Darwin, Australia.

Cherie Whitbread (C)

Menzies School of Health Research, Darwin, Australia.
Royal Darwin Hospital, Darwin, Australia.

Marie Kirkwood (M)

Menzies School of Health Research, Darwin, Australia.

Sian Graham (S)

Menzies School of Health Research, Darwin, Australia.

Paula Van Dokkum (P)

Baker IDI Heart and Diabetes Institute, Alice Springs, Australia.
Alice Springs Hospital, Alice Springs, Australia.

H David McIntyre (HD)

Mater Medical Research Institute, Brisbane, Australia.
Obstetric Medicine, University of Queensland, Brisbane, Australia.

Jonathan E Shaw (JE)

Clinical and Population Health Research, Baker Heart and Diabetes Institute, Melbourne, Australia.

Alex Brown (A)

South Australian Health and Medical Research Institute, Adelaide, Australia.

Kerin O'Dea (K)

Population Health Research, University of South Australia, Adelaide, Australia.

Christine Connors (C)

Darwin Region & Strategic Primary Health Care Branch, Top End Health Service, Northern Territory Department of Health, Darwin, Australia.

Jeremy Oats (J)

Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.

Paul Zimmet (P)

Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia.

Jacqueline Boyle (J)

Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Louise Maple-Brown (L)

Menzies School of Health Research, Darwin, Australia.
Royal Darwin Hospital, Darwin, Australia.

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