Investigating the association between prenatal provider specialty and postpartum glucose testing in people with gestational diabetes: a retrospective analysis of a population-based Canadian cohort.

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dc.contributor.advisorMetcalfe, Amy
dc.contributor.authorCharlong, Kathleen Mackenzie
dc.contributor.committeememberRabi, Doreen
dc.contributor.committeememberCuthbert, Colleen
dc.date2024-11
dc.date.accessioned2024-07-09T16:54:53Z
dc.date.available2024-07-09T16:54:53Z
dc.date.issued2024-07-03
dc.description.abstractBackground Gestational diabetes mellitus (GDM) increases future risk of type 2 diabetes and cardiovascular disease. Diabetes Canada guidelines recommend postpartum glucose tolerance testing for everyone with GDM, yet uptake is low. Most evidence of barriers to testing comes from international sources and may not be generalizable to the Canadian perinatal context. Canadian maternity care providers include general practitioners (GPs), obstetricians (OBs), and registered midwives (RMs), with care models that differ from each other and from international providers of the same titles. There is a need for Canadian population-based studies exploring systems-level factors associated with low postpartum screening uptake. Methods We used de-identified population-based data on all births in Alberta, Canada between 2017 and 2018. We identified prenatal care provider specialty, glucose testing incidence, and cohort demographics. The study outcomes were 1) reciept of the gold standard protocol: oral glucose tolerance test (OGTT) within 6 weeks to 6 months, and 2) any glucose test occurring within 6 weeks to 1 year postpartum. We used logistic regression, adjusted for clinically relevant covariates, to estimate an association between test uptake and provider specialty. Results From 105,691 births we identified a GDM cohort of 9,884 eligible births. Cohort proportions of each prenatal care provider were OB (58.6%), GP (38.5%), and RM (2.9%). Overall test incidence was low; 22.2% (95% CI: 21.4 – 23.1) received gold standard testing and 53.9% (95% CI: 52.9 – 54.9) received any testing. When compared to the OB group, people in the GP group were less likely to receive follow-up testing (ORGS= 0.86, 95% CI: 0.77 – 0.95; ORAny= 0.88, 95% CI: 0.81 – 0.96). Those with RM care were also less likely to receive follow-up testing (ORGS= 0.67, 95% CI: 0.46 – 0.96; ORAny= 0.88, 95% CI: 0.67 – 1.15) when compared to the OB group. Discussion The overall proportion of people receiving postpartum glucose testing was low, indicating that efforts to improve screening uptake should be targeted to all care providers.
dc.identifier.citationCharlong, K. M. (2024). Investigating the association between prenatal provider specialty and postpartum glucose testing in people with gestational diabetes: a retrospective analysis of a population-based Canadian cohort (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.
dc.identifier.urihttps://hdl.handle.net/1880/119150
dc.language.isoen
dc.publisher.facultyGraduate Studies
dc.publisher.institutionUniversity of Calgary
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subjectGestational diabetes mellitus
dc.subjectPostpartum
dc.subjectGlucose
dc.subjectPrenatal
dc.subjectMidwife
dc.subjectGeneral practitioner
dc.subjectObstetrician
dc.subject.classificationEpidemiology
dc.subject.classificationObstetrics and Gynecology
dc.titleInvestigating the association between prenatal provider specialty and postpartum glucose testing in people with gestational diabetes: a retrospective analysis of a population-based Canadian cohort.
dc.typemaster thesis
thesis.degree.disciplineMedicine – Community Health Sciences
thesis.degree.grantorUniversity of Calgary
thesis.degree.nameMaster of Science (MSc)
ucalgary.thesis.accesssetbystudentI require a thesis withhold – I need to delay the release of my thesis due to a patent application, and other reasons outlined in the link above. I have/will need to submit a thesis withhold application.
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