Endocrine Abstracts

JOINT738

Background: The prevalence of gestational diabetes mellitus (GDM) in New Zealand has increased from 1.4% in 1991 to 6.2% in 2019, comparable to an estimated 7.8% in Europe in 2021, though lower than rates up to 27% reported in Asian and African. National rates of GDM are significantly higher for Māori (12%) compared to European women (around 7%). After GDM, there is up to a 20-fold increased risk of developing diabetes, and an increased age-adjusted risk of major cardiovascular (CV) events and renal disease compared to women who remain normoglycemic during pregnancy. There are few reports on post-partum screening for women diagnosed with GDM in NZ and internationally. One national study reported low post-partum screening rates for type 2 diabetes for women with GDM (56%) and unacceptably low rates for Māori women (38%), which also varied by maternal age, deprivation and region. No recommendations have been identified for screening of CV risk factors (blood pressure, lipids, smoking status) or renal disease in NZ. A large, representative United Kingdom study reported 80% of women were screened for hypertension in the first year post-partum (declining to 48% by the third year), 58% for diabetes, and only 46% and 11% for smoking status and lipids, respectively.

Aim: To identify factors associated with post-partum screening in women with GDM to increase screening and risk management, particularly for Māori and Pacific women.

Methods: Anonymised medical information will be obtained for women diagnosed with GDM in Auckland from a primary health-care provider, covering approximately 50% of the Auckland population, to identify factors associated with post-partum screening for cardiometabolic and renal disease. Approximately 250 of the total women will be randomly selected and complete a self-administered questionnaire and telephone interview to identify facilitators and barriers to screening. Comparisons will be made between women who complete screening and those who do not, utilising chi-square or t-tests for demographic and health-related variables, Cox proportional hazard ratios for calculating time-to-first cardiometabolic events, Kaplan-Meier to generate outcome (survival) curves and logistic regression to generate odds ratios for health outcomes.

Results: Initial results for the total cohort will be presented if available. Findings are expected to translate across diverse populations, identify solutions to increase post-partum screening and improve risk management and health outcomes for at-risk women.