Improving postpartum screening after diabetes in pregnancy

Results of a pilot study in remote Australia

Renae Kirkham, Diana MacKay, Federica Barzi, Cherie Whitbread, Marie Kirkwood, Sian Graham, Paula Van Dokkum, H. David McIntyre, Jonathan E. Shaw, Alex Brown, Kerin O'Dea, Christine Connors, Jeremy Oats, Paul Zimmet, Jacqueline Boyle, Louise Maple-Brown

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)430-435
    Number of pages6
    JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
    Volume59
    Issue number3
    Early online date2 Oct 2018
    DOIs
    Publication statusPublished - Jun 2019

    Fingerprint

    Pregnancy in Diabetics
    Postpartum Period
    Glucose Tolerance Test
    Blood Glucose
    Northern Territory
    Text Messaging
    Glucose
    Health
    Sample Size
    Fasting

    Cite this

    Kirkham, Renae ; MacKay, Diana ; Barzi, Federica ; Whitbread, Cherie ; Kirkwood, Marie ; Graham, Sian ; Van Dokkum, Paula ; McIntyre, H. David ; Shaw, Jonathan E. ; Brown, Alex ; O'Dea, Kerin ; Connors, Christine ; Oats, Jeremy ; Zimmet, Paul ; Boyle, Jacqueline ; Maple-Brown, Louise. / Improving postpartum screening after diabetes in pregnancy : Results of a pilot study in remote Australia. In: Australian and New Zealand Journal of Obstetrics and Gynaecology. 2019 ; Vol. 59, No. 3. pp. 430-435.
    @article{7a3bd0377d374a14abd58399bd4bd6d7,
    title = "Improving postpartum screening after diabetes in pregnancy: Results of a pilot study in remote Australia",
    abstract = "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.",
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    author = "Renae Kirkham and Diana MacKay and Federica Barzi and Cherie Whitbread and Marie Kirkwood and Sian Graham and {Van Dokkum}, Paula and McIntyre, {H. David} and Shaw, {Jonathan E.} and Alex Brown and Kerin O'Dea and Christine Connors and Jeremy Oats and Paul Zimmet and Jacqueline Boyle and Louise Maple-Brown",
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    Kirkham, R, MacKay, D, Barzi, F, Whitbread, C, Kirkwood, M, Graham, S, Van Dokkum, P, McIntyre, HD, Shaw, JE, Brown, A, O'Dea, K, Connors, C, Oats, J, Zimmet, P, Boyle, J & Maple-Brown, L 2019, 'Improving postpartum screening after diabetes in pregnancy: Results of a pilot study in remote Australia', Australian and New Zealand Journal of Obstetrics and Gynaecology, vol. 59, no. 3, pp. 430-435. https://doi.org/10.1111/ajo.12894

    Improving postpartum screening after diabetes in pregnancy : Results of a pilot study in remote Australia. / Kirkham, Renae; MacKay, Diana; Barzi, Federica; Whitbread, Cherie; Kirkwood, Marie; Graham, Sian; Van Dokkum, Paula; McIntyre, H. David; Shaw, Jonathan E.; Brown, Alex; O'Dea, Kerin; Connors, Christine; Oats, Jeremy; Zimmet, Paul; Boyle, Jacqueline; Maple-Brown, Louise.

    In: Australian and New Zealand Journal of Obstetrics and Gynaecology, Vol. 59, No. 3, 06.2019, p. 430-435.

    Research output: Contribution to journalArticleResearchpeer-review

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    AU - Kirkham, Renae

    AU - MacKay, Diana

    AU - Barzi, Federica

    AU - Whitbread, Cherie

    AU - Kirkwood, Marie

    AU - Graham, Sian

    AU - Van Dokkum, Paula

    AU - McIntyre, H. David

    AU - Shaw, Jonathan E.

    AU - Brown, Alex

    AU - O'Dea, Kerin

    AU - Connors, Christine

    AU - Oats, Jeremy

    AU - Zimmet, Paul

    AU - Boyle, Jacqueline

    AU - Maple-Brown, Louise

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    N2 - 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.

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