Postpartum Oral Glucose Tolerance Test: Predictors Of Testing And Abnormal Results In A Community Hospital

INTRODUCTION: To evaluate the predictors of compliance to postpartum oral glucose tolerance testing (OGTT) and factors predicting diabetes mellitus or impaired glucose tolerance( IGT) postpartum METHODS: A retrospective cohort study of gestational diabetic patients’, who delivered from January 2013 to December 2015. Factors predicting compliance to postpartum OGTT and abnormal results was determined using logistic regression analysis. RESULTS: Of the 514 patients included, 178 (35%) had a postpartum OGTT; of those 7(4%) had diabetes mellitus and 16 (9%) had impaired glucose tolerance. Predictors of postpartum OGTT included: Gestational age at GDM diagnosis: 24 - 30 weeks vs. less than 24 weeks (OR=0.64 , p = 0.065), greater than 30 weeks vs. less than 24 weeks (OR= 0.54,p= 0.007); Gestational age at initiation of care: greater than 24 weeks vs. less than 24 weeks (OR = 0.58,p = 0.016); Any adverse perinatal outcome vs. none (OR= 0.63,p= 0.014); Race: Black/African vs Asian and Hispanic vs. Asian;(OR = 0.53 p= 0.009; OR= 0.63 p= 0.12 respectively). Predictors of DM and IGT were : requirement for pharmacological vs. diet control (OR = 2.9, p = 0.036); Gestational-age at diagnosis of GDM: greater than 24 weeks vs. less than 24 weeks (OR = 0.21, p= 0.001). CONCLUSION: Early diagnosis of GDM and early initiation of prenatal care increased odds of OGTT. Black race and having any adverse perinatal outcome predicted poor postpartum OGTT compliance. GDM patients diagnosed early antepartum and requiring medication are at higher risk of DM and IGT.