Receipt of postpartum diabetes screening after gestational diabetes mellitus in the United States, 2016-2022.

AIMS: To examine temporal trends in, as well as social and clinical factors associated 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 Risk Assessment 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 was 55.8% (95% CI: 54.8-56.9). Screening prevalence increased from 2016 (55.6%) to 2019 (60.3%), declined at the onset of the COVID-19 pandemic (2020: 52.6%) and subsequently increased through 2022 (55.8%). Screening prevalence was 6%-38% higher among individuals who were ≥30 years of age; identified as racial or ethnic minoritized groups; did not graduate from high school; had public prenatal health insurance; had pre-pregnancy overweight or obesity and had adequate plus prenatal care. Screening prevalence was 5%-14% lower among individuals with a previous live birth, preterm birth and residents of rural areas, the South or U.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.