Maternal Race/Ethnicity and Postpartum Diabetes Screening: A Systematic Review and Meta-Analysis

Herrick, Cynthia; Puri, Ritika; Rahaman, Rana; Hardi, Angela; Stewart, Karyn; Colditz, Graham A.

doi:10.1089/jwh.2019.8081

Cited by 21 publications

(21 citation statements)

References 47 publications

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“…Black and Hispanic individuals express the highest levels of interest in referral, yet less than 5% of eligible participants are being referred to these programs [94]. Postpartum screening rates in women with gestational diabetes are also low, especially among Black women, despite their increased risk of converting to type 2 DM [95,96]. Similarly, Black women with pregnancy-related hypertension have more difficulty attending in-person postpartum visits, making postpartum treatment less accessible [97].…”

Section: Treatment Disparities In Women From Racial/ethnic Minoritmentioning

confidence: 99%

Disparities in Cardiovascular Care and Outcomes for Women From Racial/Ethnic Minority Backgrounds

Balla

Gomez

Rodríguez

2020

Curr Treat Options Cardio Med

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Purpose of review Racial, ethnic, and gender disparities in cardiovascular care are well-documented. This review aims to highlight the disparities and impact on a group particularly vulnerable to disparities, women from racial/ethnic minority backgrounds. Recent findings Women from racial/ethnic minority backgrounds remain underrepresented in major cardiovascular trials, limiting the generalizability of cardiovascular research to this population. Certain cardiovascular risk factors are more prevalent in women from racial/ethnic minority backgrounds, including traditional risk factors such as hypertension, obesity, and diabetes. Female-specific risk factors including gestational diabetes and preeclampsia as well as non-traditional psychosocial risk factors like depressive and anxiety disorders, increased child care, and familial and home care responsibility have been shown to increase risk for cardiovascular disease events in women more so than in men, and disproportionately affect women from racial/ethnic minority backgrounds. Despite this, minimal interventions to address differential risk have been proposed. Furthermore, disparities in treatment and outcomes that disadvantage minority women persist. The limited improvement in outcomes over time, especially among non-Hispanic Black women, is an area that requires further research and active interventions. Summary Understanding the lack of representation in cardiovascular trials, differential cardiovascular risk, and disparities in treatment and outcomes among women from racial/ethnic minority backgrounds highlights opportunities for improving cardiovascular care among this particularly vulnerable population.

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Section: Treatment Disparities In Women From Racial/ethnic Minoritmentioning

confidence: 99%

Disparities in Cardiovascular Care and Outcomes for Women From Racial/Ethnic Minority Backgrounds

Balla

Gomez

Rodríguez

2020

Curr Treat Options Cardio Med

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“…Feedback from women was the inability to cook new food with busyness of motherhood and or work. As previously stated, Black women have the lowest postnatal screening rates, (15) the population of Lewisham is 46% Black and Minority Ethnic, and women were being signposted to White European recipes. Women wanted to be able to adjust their usual diet to one that would help prevent T2DM or worsening GDM, and not have to cook two different meals for themselves and their family.…”

Section: Discussionmentioning

confidence: 87%

“…A retrospective study conducted in She eld, found that 74% of women who did not attend were in the two most deprived quintiles, including smokers, unemployed and those who did not breastfeed. ( 14) Furthermore, a systematic review (15) found that Black women had the lowest postnatal screening rates despite the higher risk for T2DM, highlighting a need for targeting screening and prevention.…”

Section: Introductionmentioning

confidence: 99%

Using Population Health Management to improve screening of women with history of gestational diabetes in an urban setting

Bridle

Cross

Danielli

et al. 2022

Preprint

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Background The human and financial costs of diabetes related illness and treatment are significant and increasing. This is also true of women who develop gestational diabetes in pregnancy, the majority of which are subsequently likely to develop type 2 diabetes. The National Institute for Health & Care Excellence (NICE) guidance sets out clear expectations of the care pregnant women should receive. However, evidence suggests reality is a long way from this guidance. Methods Data was collected from the population health management system covering the London borough of Lewisham. This was used to compare actual care with NICE guidance. The results were used to target cultural appropriate interventions to improve care. ResultsThe care pregnant women were receiving fell a long way short of NICE guidance, with 84% of women not being screened at the initial 3 months postpartum and 99% of women not being screened annually. This is significantly worse than the UK average. ConclusionUsing population health management is beneficial in identifying the gap between actual care and best practice. The process of examining the data through population health management also enable targeted culturally appropriate interventions.

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“… 20 40 Type 2 diabetes diagnoses in primary care records may also merely reflect the likelihood of screening; a recent systematic review, although only using studies of US women, found that Asian women were more likely to be tested for type 2 diabetes following GDM than White women; pooled proportion being screened was 50% in Asian and 35% in White. 41 However, if an indicator of CMD or type 2 diabetes in primary care records merely did reflect a tendency to engage with health services, there would have been more evidence of an association between the two measures. Nonetheless, while in the UK it is recommended that women who have experienced GDM undergo glucose monitoring at 6 weeks postpartum and annually thereafter, 16 evidence suggests patchy implementation of this guidance.…”

Section: Discussionmentioning

confidence: 99%

Development of type 2 diabetes in women with comorbid gestational diabetes and common mental disorders in the Born in Bradford cohort

et al. 2022

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ObjectivesTo compare, in a population of women with gestational diabetes mellitus (GDM), the time to diagnosis of Type 2 diabetes in those with and without common mental disorder (CMD) (depression and/or anxiety) during pregnancy.Design and settingprospective study of the Born in Bradford cohort in Bradford, UK.Participants909 women diagnosed with GDM between 2007 and 2010, with linkage to their primary care records until 2017. The exposed population were women with an indicator of CMD during pregnancy in primary care records. The unexposed were those without an indicator.Outcome measuresTime to diagnosis of type 2 diabetes as indicated by a diagnosis in primary care records.Analysistime to event analysis using Cox regression was employed. Multiple imputation by chained equations was implemented to handle missing data. Models were adjusted for maternal age, ethnicity, education, preconception CMD and tobacco smoking during pregnancy.Results165 women (18%) were diagnosed with type 2 diabetes over a follow-up period of around 10 years. There was no evidence of an effect of antenatal CMD on the development of type 2 diabetes following GDM (adjusted HR 0.95; 95% CI 0.57 to 1.57).ConclusionsWomen with CMD were not at an increased risk of type 2 diabetes following GDM. This is reassuring for women with these co-morbidities but requires replication in other study populations.

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Maternal Race/Ethnicity and Postpartum Diabetes Screening: A Systematic Review and Meta-Analysis

Cited by 21 publications

References 47 publications

Disparities in Cardiovascular Care and Outcomes for Women From Racial/Ethnic Minority Backgrounds

Disparities in Cardiovascular Care and Outcomes for Women From Racial/Ethnic Minority Backgrounds

Using Population Health Management to improve screening of women with history of gestational diabetes in an urban setting

Development of type 2 diabetes in women with comorbid gestational diabetes and common mental disorders in the Born in Bradford cohort

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