Compliance with National Institute of Health and Care Excellence risk-based screening for Gestational Diabetes Mellitus in nulliparous women

Nicolai M. Murphy; Fergus P. McCarthy; Ali S. Khashan; Jenny E. Myers; Nigel A B Simpson; Patricia M. Kearney; Richard A. Greene; Lucilla Poston; Louise C. Kenny

doi:10.1016/j.ejogrb.2016.01.044

Compliance with National Institute of Health and Care Excellence risk-based screening for Gestational Diabetes Mellitus in nulliparous women

Nicolai M. Murphy^*, Fergus P. McCarthy, Ali S. Khashan, Jenny E. Myers, Nigel A B Simpson, Patricia M. Kearney, Richard A. Greene, Lucilla Poston, Louise C. Kenny

^*Corresponding author for this work

Women & Children's Health

Research output: Contribution to journal › Article › peer-review

18 Citations (Scopus)

Abstract

Objective

To investigate compliance with risk-based screening for Gestational Diabetes Mellitus (GDM) in a nulliparous cohort.

Design

A retrospective analysis of nulliparous women recruited to a prospective cohort, the Screening for Pregnancy Endpoints (SCOPE) study, was performed. Population included 2428 healthy nulliparous women with singleton pregnancies, recruited within Cork, Ireland; and Manchester, Leeds and London, United Kingdom. Compliance with risk factor screening for GDM was assessed in relation to the following risk factors: obesity, family history of diabetes and increased ethnic risk. GDM was diagnosed using an oral Glucose Tolerance Test (GTT) with locally employed diagnostic criteria. Statistical analysis was performed using Statistical Packages for Social Sciences (SPSS V22). Descriptive statistics are presented for the various baseline characteristics using numbers and percentages. Cross tabulation was used to compare relevant groups. When comparing group distributions Chi-square test was used. p-value <0.05 was considered statistically significant.

Results

In the entire cohort of 2432 women, 27% (650 Women) had one or more identifiable risk factors as defined by National Institute of Health and Care Excellence (NICE) for GDM. Of those that had identifiable GDM risk factors according to the NICE guidelines, 395(60.8%) were appropriately screened. 253 (38.9%) had risk factors but were not screened. 261 (14.6%) had no GDM NICE risk factors but were screened with an oral GTT. Women with a risk factor that were screened with a GTT had an 8.9% (n = 34) prevalence of GDM. Of those that were screened but did not have a risk factor 7.7% (n = 20) were diagnosed with GDM. Overall, 2% (54 women) of the cohort had a diagnosis of GDM. Ethnicity was the risk factor most likely to be missed (n = 55, 66.3%). The GTT test was completed within the recommended gestational window (24−28 weeks) 56.6% (n = 371) of the time.

Conclusion

This study highlights poor compliance with risk factor screening for GDM in nulliparous women. Further investigation into the underlying reasons is warranted as well as the implications for pregnancy outcome.

Original language	English
Pages (from-to)	60-65
Number of pages	6
Journal	European Journal of Obstetrics Gynecology and Reproductive Biology
Volume	199
Early online date	8 Feb 2016
DOIs	https://doi.org/10.1016/j.ejogrb.2016.01.044
Publication status	Published - 1 Apr 2016

Keywords

Compliance
Gestational diabetes
Pregnancy
Risk factor
Screening

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ejogrb.2016.01.044

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Murphy, N. M., McCarthy, F. P., Khashan, A. S., Myers, J. E., Simpson, N. A. B., Kearney, P. M., Greene, R. A., Poston, L., & Kenny, L. C. (2016). Compliance with National Institute of Health and Care Excellence risk-based screening for Gestational Diabetes Mellitus in nulliparous women. European Journal of Obstetrics Gynecology and Reproductive Biology, 199, 60-65. https://doi.org/10.1016/j.ejogrb.2016.01.044

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title = "Compliance with National Institute of Health and Care Excellence risk-based screening for Gestational Diabetes Mellitus in nulliparous women",

abstract = "ObjectiveTo investigate compliance with risk-based screening for Gestational Diabetes Mellitus (GDM) in a nulliparous cohort.DesignA retrospective analysis of nulliparous women recruited to a prospective cohort, the Screening for Pregnancy Endpoints (SCOPE) study, was performed. Population included 2428 healthy nulliparous women with singleton pregnancies, recruited within Cork, Ireland; and Manchester, Leeds and London, United Kingdom. Compliance with risk factor screening for GDM was assessed in relation to the following risk factors: obesity, family history of diabetes and increased ethnic risk. GDM was diagnosed using an oral Glucose Tolerance Test (GTT) with locally employed diagnostic criteria. Statistical analysis was performed using Statistical Packages for Social Sciences (SPSS V22). Descriptive statistics are presented for the various baseline characteristics using numbers and percentages. Cross tabulation was used to compare relevant groups. When comparing group distributions Chi-square test was used. p-value <0.05 was considered statistically significant.ResultsIn the entire cohort of 2432 women, 27% (650 Women) had one or more identifiable risk factors as defined by National Institute of Health and Care Excellence (NICE) for GDM. Of those that had identifiable GDM risk factors according to the NICE guidelines, 395(60.8%) were appropriately screened. 253 (38.9%) had risk factors but were not screened. 261 (14.6%) had no GDM NICE risk factors but were screened with an oral GTT. Women with a risk factor that were screened with a GTT had an 8.9% (n = 34) prevalence of GDM. Of those that were screened but did not have a risk factor 7.7% (n = 20) were diagnosed with GDM. Overall, 2% (54 women) of the cohort had a diagnosis of GDM. Ethnicity was the risk factor most likely to be missed (n = 55, 66.3%). The GTT test was completed within the recommended gestational window (24−28 weeks) 56.6% (n = 371) of the time.ConclusionThis study highlights poor compliance with risk factor screening for GDM in nulliparous women. Further investigation into the underlying reasons is warranted as well as the implications for pregnancy outcome.",

keywords = "Compliance, Gestational diabetes, Pregnancy, Risk factor, Screening",

author = "Murphy, {Nicolai M.} and McCarthy, {Fergus P.} and Khashan, {Ali S.} and Myers, {Jenny E.} and Simpson, {Nigel A B} and Kearney, {Patricia M.} and Greene, {Richard A.} and Lucilla Poston and Kenny, {Louise C.}",

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Murphy, NM, McCarthy, FP, Khashan, AS, Myers, JE, Simpson, NAB, Kearney, PM, Greene, RA, Poston, L & Kenny, LC 2016, 'Compliance with National Institute of Health and Care Excellence risk-based screening for Gestational Diabetes Mellitus in nulliparous women', European Journal of Obstetrics Gynecology and Reproductive Biology, vol. 199, pp. 60-65. https://doi.org/10.1016/j.ejogrb.2016.01.044

Compliance with National Institute of Health and Care Excellence risk-based screening for Gestational Diabetes Mellitus in nulliparous women. / Murphy, Nicolai M.; McCarthy, Fergus P.; Khashan, Ali S. et al.
In: European Journal of Obstetrics Gynecology and Reproductive Biology, Vol. 199, 01.04.2016, p. 60-65.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Compliance with National Institute of Health and Care Excellence risk-based screening for Gestational Diabetes Mellitus in nulliparous women

AU - Murphy, Nicolai M.

AU - McCarthy, Fergus P.

AU - Khashan, Ali S.

AU - Myers, Jenny E.

AU - Simpson, Nigel A B

AU - Kearney, Patricia M.

AU - Greene, Richard A.

AU - Poston, Lucilla

AU - Kenny, Louise C.

PY - 2016/4/1

Y1 - 2016/4/1

N2 - ObjectiveTo investigate compliance with risk-based screening for Gestational Diabetes Mellitus (GDM) in a nulliparous cohort.DesignA retrospective analysis of nulliparous women recruited to a prospective cohort, the Screening for Pregnancy Endpoints (SCOPE) study, was performed. Population included 2428 healthy nulliparous women with singleton pregnancies, recruited within Cork, Ireland; and Manchester, Leeds and London, United Kingdom. Compliance with risk factor screening for GDM was assessed in relation to the following risk factors: obesity, family history of diabetes and increased ethnic risk. GDM was diagnosed using an oral Glucose Tolerance Test (GTT) with locally employed diagnostic criteria. Statistical analysis was performed using Statistical Packages for Social Sciences (SPSS V22). Descriptive statistics are presented for the various baseline characteristics using numbers and percentages. Cross tabulation was used to compare relevant groups. When comparing group distributions Chi-square test was used. p-value <0.05 was considered statistically significant.ResultsIn the entire cohort of 2432 women, 27% (650 Women) had one or more identifiable risk factors as defined by National Institute of Health and Care Excellence (NICE) for GDM. Of those that had identifiable GDM risk factors according to the NICE guidelines, 395(60.8%) were appropriately screened. 253 (38.9%) had risk factors but were not screened. 261 (14.6%) had no GDM NICE risk factors but were screened with an oral GTT. Women with a risk factor that were screened with a GTT had an 8.9% (n = 34) prevalence of GDM. Of those that were screened but did not have a risk factor 7.7% (n = 20) were diagnosed with GDM. Overall, 2% (54 women) of the cohort had a diagnosis of GDM. Ethnicity was the risk factor most likely to be missed (n = 55, 66.3%). The GTT test was completed within the recommended gestational window (24−28 weeks) 56.6% (n = 371) of the time.ConclusionThis study highlights poor compliance with risk factor screening for GDM in nulliparous women. Further investigation into the underlying reasons is warranted as well as the implications for pregnancy outcome.

AB - ObjectiveTo investigate compliance with risk-based screening for Gestational Diabetes Mellitus (GDM) in a nulliparous cohort.DesignA retrospective analysis of nulliparous women recruited to a prospective cohort, the Screening for Pregnancy Endpoints (SCOPE) study, was performed. Population included 2428 healthy nulliparous women with singleton pregnancies, recruited within Cork, Ireland; and Manchester, Leeds and London, United Kingdom. Compliance with risk factor screening for GDM was assessed in relation to the following risk factors: obesity, family history of diabetes and increased ethnic risk. GDM was diagnosed using an oral Glucose Tolerance Test (GTT) with locally employed diagnostic criteria. Statistical analysis was performed using Statistical Packages for Social Sciences (SPSS V22). Descriptive statistics are presented for the various baseline characteristics using numbers and percentages. Cross tabulation was used to compare relevant groups. When comparing group distributions Chi-square test was used. p-value <0.05 was considered statistically significant.ResultsIn the entire cohort of 2432 women, 27% (650 Women) had one or more identifiable risk factors as defined by National Institute of Health and Care Excellence (NICE) for GDM. Of those that had identifiable GDM risk factors according to the NICE guidelines, 395(60.8%) were appropriately screened. 253 (38.9%) had risk factors but were not screened. 261 (14.6%) had no GDM NICE risk factors but were screened with an oral GTT. Women with a risk factor that were screened with a GTT had an 8.9% (n = 34) prevalence of GDM. Of those that were screened but did not have a risk factor 7.7% (n = 20) were diagnosed with GDM. Overall, 2% (54 women) of the cohort had a diagnosis of GDM. Ethnicity was the risk factor most likely to be missed (n = 55, 66.3%). The GTT test was completed within the recommended gestational window (24−28 weeks) 56.6% (n = 371) of the time.ConclusionThis study highlights poor compliance with risk factor screening for GDM in nulliparous women. Further investigation into the underlying reasons is warranted as well as the implications for pregnancy outcome.

KW - Compliance

KW - Gestational diabetes

KW - Pregnancy

KW - Risk factor

KW - Screening

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U2 - 10.1016/j.ejogrb.2016.01.044

DO - 10.1016/j.ejogrb.2016.01.044

M3 - Article

AN - SCOPUS:84960907043

SN - 0301-2115

VL - 199

SP - 60

EP - 65

JO - European Journal of Obstetrics Gynecology and Reproductive Biology

JF - European Journal of Obstetrics Gynecology and Reproductive Biology

ER -

Compliance with National Institute of Health and Care Excellence risk-based screening for Gestational Diabetes Mellitus in nulliparous women

Abstract

Keywords

UN SDGs

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