Abstract
Background: Postpartum care for women with gestational diabetes mellitus (GDM) to test for type 2 diabetes mellitus (T2DM) remains sub‐optimal, despite the substantial risk of future T2DM, and of complications of untreated T2DM. This systematic review aimed to examine clinician views and knowledge regarding postpartum healthcare provision for GDM.
Method: PubMed, Web of Science, EMBASE and CINAHL were searched. Qualitative studies, with clinicians as participants, which reported pre‐specified outcomes including barriers and facilitators to postpartum care for GDM (PROSPERO 2013:CRD42013003619) were included. Two authors independently assessed quality and undertook thematic synthesis.
Results: Eleven surveys and two interview studies were included (4435 clinicians). Key themes included adequacy of knowledge of risk of T2DM, gaps between knowledge and practice relating to postpartum screening, and differing perceptions of the value of postpartum screening. Key themes relating to women's needs included barriers to accessing health care and a need for improved GDM education. Studies also reported shortfalls in systems to ensure postpartum screening occurs, and a need to improve communication and collaboration relating to care of women who have experienced GDM. Data from the surveys was often limited in its depth and ability to identify remedial strategies.
Conclusions: The evident gaps between clinicians' knowledge of future risk of T2DM, but low practice of postpartum screening of women with GDM, need to be closed. More interview studies are required in order to further explore the reasons for these gaps, and to help plan ways to improve future care of women with previous GDM.
Method: PubMed, Web of Science, EMBASE and CINAHL were searched. Qualitative studies, with clinicians as participants, which reported pre‐specified outcomes including barriers and facilitators to postpartum care for GDM (PROSPERO 2013:CRD42013003619) were included. Two authors independently assessed quality and undertook thematic synthesis.
Results: Eleven surveys and two interview studies were included (4435 clinicians). Key themes included adequacy of knowledge of risk of T2DM, gaps between knowledge and practice relating to postpartum screening, and differing perceptions of the value of postpartum screening. Key themes relating to women's needs included barriers to accessing health care and a need for improved GDM education. Studies also reported shortfalls in systems to ensure postpartum screening occurs, and a need to improve communication and collaboration relating to care of women who have experienced GDM. Data from the surveys was often limited in its depth and ability to identify remedial strategies.
Conclusions: The evident gaps between clinicians' knowledge of future risk of T2DM, but low practice of postpartum screening of women with GDM, need to be closed. More interview studies are required in order to further explore the reasons for these gaps, and to help plan ways to improve future care of women with previous GDM.
| Original language | English |
|---|---|
| Pages (from-to) | 49-50 |
| Number of pages | 2 |
| Journal | Journal of Paediatrics and Child Health |
| Volume | 50 |
| Issue number | 1 |
| Early online date | 19 Mar 2014 |
| DOIs | |
| Publication status | Published - 2014 |
| Externally published | Yes |
| Event | Perinatal Society of Australia & New Zealand: 18th Annual Congress - Crown Perth, Perth, Australia Duration: 6 Apr 2014 → 9 Apr 2014 Conference number: 18 |
Keywords
- postpartum care
- gestational diabetes mellitus
- type 2 diabetes mellitus
- systematic review