ABSTRACT:
Aims: To examine temporal trends in, as well as social and clinical factorsassociated with, the prevalence of postpartum diabetes screening after gestational diabetes mellitus (GDM) in the United States (U.S.).
Methods: Cross-sectional, population-based data were from the Pregnancy RiskAssessment Monitoring System (PRAMS) 2016–2022 from 44 U.S. states and jurisdictions. The analytic sample included postpartum individuals with self-reported GDM who attended a postpartum checkup and reported on postpartum diabetes screening (n = 21,559). Overall and annual prevalence of postpartum diabetes screening were calculated, and associations between social and clinical factors and postpartum diabetes screening were examined using multivariable modified Poisson regression (adjusted prevalence ratios [aPR] with 95%confidence intervals [CI]).
Results: Overall weighted prevalence of postpartum diabetes screening was55.8% (95% CI: 54.8–56.9). Screening prevalence increased from 2016 (55.6%) to2019 (60.3%), declined at the onset of the COVID-19 pandemic (2020: 52.6%) andsubsequently increased through 2022 (55.8%). Screening prevalence was 6%–38%higher among individuals who were ≥30 years of age; identified as racial or ethnicminoritized groups; did not graduate from high school; had public prenatalhealth insurance; had pre-pregnancy overweight or obesity and had adequateplus prenatal care. Screening prevalence was 5%–14% lower among individualswith a previous live birth, preterm birth and residents of rural areas, the South orU.S. Territories.
Conclusions: While postpartum diabetes screening has increased and aligns with recognized risk factors, overall prevalence remains suboptimal. Postpartum diabetes screening represents a critical opportunity to identify individuals at elevated cardiometabolic disease risk and initiate timely interventions.