TY - JOUR
T1 - Maternal Race/Ethnicity and Postpartum Diabetes Screening
T2 - A Systematic Review and Meta-Analysis
AU - Herrick, Cynthia J.
AU - Herrick, Cynthia J.
AU - Puri, Ritika
AU - Rahaman, Rana
AU - Hardi, Angela
AU - Stewart, Karyn
AU - Colditz, Graham A.
N1 - Funding Information:
C.J.H. was supported for research reported in this publication by Award No. KL2TR002346 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health, and C.J.H. is currently supported by 1K23HD096204-01A1. R.P. was supported by the T32DK007120-44 through NIDDK. K.S. was supported by T32CA190194 through NCI, the Siteman Cancer Center, and the Foundation for Barnes Jewish Hospital. G.A.C. is supported, in part, by the Foundation for Barnes Jewish Hospital and the Washington University Institute for Clinical and Translational Sciences grant UL1TR000448. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funding agencies had no role in the design or conduct of this study.
Funding Information:
The authors acknowledge the Washington University Institute for Clinical and Translational Sciences, Foundation for Barnes Jewish Hospital, NCATS, NCI, and NIDDK at the National Institutes of Health for supporting this research. We also thank Roxann Williams, MPH for assistance with article formatting and preparation.
Publisher Copyright:
© Copyright 2020, Mary Ann Liebert, Inc.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Introduction: Fifty percent of women with gestational diabetes mellitus (GDM) may progress to type 2 diabetes with highest risk among black women. This study aims to characterize postpartum diabetes screening rates among U.S. women with GDM by racial and ethnic group to characterize potential disparities. Materials and Methods: A standardized search of Ovid-Medline, Embase, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane, ProQuest, and Clinicaltrials.gov was conducted through October 12, 2018. Of 1,555 titles reviewed, 27 studies met inclusion criteria. Meta-proportion routines with random-effects models estimated pooled postpartum screening proportion effect size (ES) with 95% confidence interval (CI) by racial and ethnic group. Heterogeneity was measured using Cochrane's Q and Higgins I2 tests. Data were stratified by intervention and data source. Results: There were 96,439 women, of whom 81,930 had race/ethnicity recorded. Heterogeneity was high (I2 = 99.7%). Postpartum screening rates were low (pooled ES 42% [95% CI 35%-48%]). Point estimates for pooled screening proportions were lower among white (pooled ES 35% [95% CI 28%-42%]) and black (pooled ES 33% [95% CI 24%-42%]) women than among Hispanic (pooled ES 45% [95% CI 37%-53%]) and Asian (pooled ES 50% [95% CI 41%-58%]) women. Interventions to improve screening were most common and effective among Hispanic women. Discussion: Postpartum screening for diabetes after GDM remains low, and black women have among the lowest postpartum screening rates despite highest risk for type 2 diabetes progression. Reporting of race/ethnicity, screening methods, and screening time frames varied across studies. Conclusion: Future studies must standardize racial/ethnic data reporting and examine interventions that address postpartum diabetes screening and prevention.
AB - Introduction: Fifty percent of women with gestational diabetes mellitus (GDM) may progress to type 2 diabetes with highest risk among black women. This study aims to characterize postpartum diabetes screening rates among U.S. women with GDM by racial and ethnic group to characterize potential disparities. Materials and Methods: A standardized search of Ovid-Medline, Embase, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane, ProQuest, and Clinicaltrials.gov was conducted through October 12, 2018. Of 1,555 titles reviewed, 27 studies met inclusion criteria. Meta-proportion routines with random-effects models estimated pooled postpartum screening proportion effect size (ES) with 95% confidence interval (CI) by racial and ethnic group. Heterogeneity was measured using Cochrane's Q and Higgins I2 tests. Data were stratified by intervention and data source. Results: There were 96,439 women, of whom 81,930 had race/ethnicity recorded. Heterogeneity was high (I2 = 99.7%). Postpartum screening rates were low (pooled ES 42% [95% CI 35%-48%]). Point estimates for pooled screening proportions were lower among white (pooled ES 35% [95% CI 28%-42%]) and black (pooled ES 33% [95% CI 24%-42%]) women than among Hispanic (pooled ES 45% [95% CI 37%-53%]) and Asian (pooled ES 50% [95% CI 41%-58%]) women. Interventions to improve screening were most common and effective among Hispanic women. Discussion: Postpartum screening for diabetes after GDM remains low, and black women have among the lowest postpartum screening rates despite highest risk for type 2 diabetes progression. Reporting of race/ethnicity, screening methods, and screening time frames varied across studies. Conclusion: Future studies must standardize racial/ethnic data reporting and examine interventions that address postpartum diabetes screening and prevention.
KW - gestational diabetes
KW - health disparities
KW - postpartum diabetes screening
KW - race and ethnicity
UR - http://www.scopus.com/inward/record.url?scp=85084783019&partnerID=8YFLogxK
U2 - 10.1089/jwh.2019.8081
DO - 10.1089/jwh.2019.8081
M3 - Article
C2 - 32074479
AN - SCOPUS:85084783019
SN - 1540-9996
VL - 29
SP - 609
EP - 621
JO - Journal of Women's Health
JF - Journal of Women's Health
IS - 5
ER -