Real-world screening for diabetes in early pregnancy: Improved screening uptake using universal glycated haemoglobin

Abstract

Aims: To improve perinatal outcomes, screening for hyperglycaemia using 75 g oral glucose tolerance test (OGTT) is recommended for all pregnant women at 24-28 weeks gestation (routine), and earlier if high-risk. Screening coverage for remote and Aboriginal Australian women is less than ideal. This study examined OGTT completion (early and routine) by women from rural and remote Western Australia compared with early glycated haemoglobin (HbA 1c ). Methods: In 2015-2018, 27 primary health care sites recruited 600 (233 Aboriginal) women aged ≥16years, without pre-existing diabetes, who delivered >30-weeks gestation. All women presenting <20weeks gestation (541) were offered an early study HbA 1c . Early OGTTs were requested at the discretion of the local clinician, with routine OGTT offered at 24-28 weeks. Results: HbA 1c uptake was high (85.