Huynh Terri, Ghaffari Neda, Bastek Jamie, Durnwald Celeste
a Maternal and Child Health Research Program, Department of OB/GYN, University of Pennsylvania, Perelman School of Medicine , Philadelphia , PA , USA.
J Matern Fetal Neonatal Med. 2017 May;30(9):1075-1079. doi: 10.1080/14767058.2016.1201472. Epub 2016 Jun 29.
To evaluate whether prenatal care in a specialized diabetes in pregnancy program (DMC) improves compliance with completion of the 2-h 75 g oral glucose tolerance test (2HrOGTT) in GDM women.
A retrospective cohort study of GDM women delivering in a university health system between January 2011 and March 2014 was performed. Women were divided into two groups: those receiving care in prenatal clinics over an 18-month period prior to the establishment of the diabetes in pregnancy clinic (pre-DMC) and those receiving prenatal care in a specialized diabetes in pregnancy clinic (post-DMC). The primary outcome was completion of the 2HrOGTT postpartum. Clinical characteristics associated with 2HrOGTT completion were evaluated. Time trend analysis was performed to evaluate month to month variation in 2HrOGTT compliance for secular trends.
A total of 292 women were analyzed, 147 post-DMC and 118 pre-DMC. The 2HrOGTT was ordered more frequently in the post-DMC compared to pre-DMC (90.0 versus 53.0%, p < 0.0001). Rates of completion of the 2HrOGTT were 49.2% post-DMC and 25.0% pre-DMC, p = 0.007. After adjusting for potential confounders, women who received prenatal care post-DMC were 2.98 times more likely to complete the 2HrOGTT compared to those receiving care pre-DMC (OR 2.98 [1.34, 6.62], p = 0.007).
Providers were 5.9 times more likely to order the recommended testing for GDM women who attended the postpartum visit in the post-DMC period. GDM women who receive prenatal care in a specialized diabetes in pregnancy program are more likely to complete the 2HrOGTT in the postpartum period.
评估妊娠糖尿病（GDM）女性在专门的妊娠糖尿病项目（DMC）中接受产前护理是否能提高其完成2小时75克口服葡萄糖耐量试验（2HrOGTT）的依从性。
对2011年1月至2014年3月在大学卫生系统分娩的GDM女性进行回顾性队列研究。女性被分为两组：在妊娠糖尿病门诊设立前的18个月内在产前诊所接受护理的女性（DMC前）和在专门的妊娠糖尿病诊所接受产前护理的女性（DMC后）。主要结局是产后完成2HrOGTT。评估与2HrOGTT完成相关的临床特征。进行时间趋势分析以评估2HrOGTT依从性随时间的逐月变化趋势。
共分析了292名女性，其中147名在DMC后，118名在DMC前。与DMC前相比，DMC后更频繁地安排2HrOGTT检查（90.0%对53.0%，p<0.0001）。DMC后2HrOGTT的完成率为49.2%，DMC前为25.0%，p = 0.007。在调整潜在混杂因素后，与DMC前接受护理的女性相比，DMC后接受产前护理的女性完成2HrOGTT的可能性高2.98倍（OR 2.98 [1.34, 6.62]，p = 0.007）。
对于在DMC后期进行产后访视的GDM女性，医护人员安排推荐检查的可能性高5.9倍。在专门的妊娠糖尿病项目中接受产前护理的GDM女性在产后更有可能完成2HrOGTT。
