CSEMO1 - Comparison of Postpartum Follow-Up Methods for Gestational Diabetes Mellitus

Abstract: Background
Postpartum screening for prediabetes and diabetes in women with prior gestational diabetes mellitus (GDM) is recommended by all clinical guidelines. However, adherence to follow-up remains suboptimal.

Objectives
This study compares the diagnostic accuracy and adherence rates of the 75 g oral glucose tolerance test (OGTT) versus fasting plasma glucose (FPG) with HbA1c in postpartum women with prior GDM, assesses the impact of an email reminder on follow-up compliance, and examines factors associated with postpartum dysglycemia and non-adherence.

Methods
In this retrospective cohort study, approved by the institutional ethics board, 537 women who delivered at our center between February 2021 and April 2024 were included. Demographic, clinical, and biochemical data were extracted from medical records. We analyzed associations between maternal characteristics, adherence to postpartum screening, and glucose intolerance as identified by both screening methods.

Results
Among participants who underwent postpartum testing, 93% completed the OGTT, 87% completed the FPG with HbA1c, and 80% completed both tests. The OGTT group revealed 22% with prediabetes and 4% with diabetes, while FPG plus HbA1c identified only 3.5% with prediabetes and 0.7% with diabetes, confirming OGTT as a more sensitive tool for detecting postpartum dysglycemia. Ongoing analysis aims to determine adherence rates and factors associated with non-compliance and to compare the results with two previously studied cohorts from the same center (2016 and 2020).

Conclusion
OGTT remains the most effective method for detecting postpartum dysglycemia. Strategies to improve adherence, including electronic reminders, may enhance long-term metabolic outcomes.