Prenatal counseling on type 2 diabetes risk, exercise, and nutrition affects the likelihood of postpartum diabetes screening after gestational diabetes

OBJECTIVE: Screening rates for type 2 diabetes after a pregnancy with gestational diabetes are inadequate. We aimed to determine how prenatal counseling on exercise, nutrition, and type 2 diabetes risk affects postpartum screening for diabetes. METHODS: Using Pregnancy Risk Assessment Monitoring System data from Colorado (2009–2011) and Massachusetts (2012–2013), we performed multivariable logistic regression to examine the relationship between prenatal counseling and postpartum screening. RESULTS: Among 556 women, prenatal counseling was associated with increased postpartum diabetes screening, after adjusting for age, parity, and receipt of Women, Infants and Children (WIC) benefits (adjusted odds ratio (AOR) 3.0 [95%CI 1.4–6.5]). This effect was modified by race/ethnicity. Primiparity (AOR 2.2 [95%CI 1.2–4.1]) and advanced maternal age (AOR 2.2 [95%CI 1.2–3.8]) were associated with increased screening, and receiving WIC benefits was associated with decreased screening (AOR 0.5 [95%CI 0.3–0.9]). CONCLUSIONS: In women with gestational diabetes, culturally appropriate counseling on future diabetes risk, nutrition, and exercise may enhance postpartum diabetes screening.