Introduction: Gestational diabetes mellitus (GDM) affects 20% of Australian pregnancies and carries an increased risk of type II diabetes in the first five years postpartum. Despite this, global rates of postpartum oral glucose tolerance testing (OGTT) are sub-optimal. We aimed to assess barriers to completion amongst women attending a post-pregnancy complication lifestyle clinic at 6 months postpartum.
Methods: We conducted a cross-sectional registry analysis of women with previous GDM from 2018–2025 (n = 411). Patients self-reported whether they completed a postpartum OGTT at their 6-month postpartum lifestyle clinic appointment. Demographics were self-reported by patients and abstracted from medical notes. Cardiometabolic health was assessed with anthropometrics, glycaemic status and haemodynamics. Descriptive statistical analysis was conducted using SPSS.
Results: A total of 256 (62%) patients reported completing a postpartum OGTT. These patients were younger, with a higher proportion of them being married, non-smokers, having a lower mean BMI (kg/m2) and reporting higher self-reported anxiety, and scoring higher for depression based on Patient Health Questionnaire-9. Being a current or former smoker was associated with a 2-fold increased likelihood of not completing a postpartum OGTT.
Conclusion: We identified key socioeconomic and clinical factors affecting postpartum OGTT non-completion in women with previous gestational diabetes. These findings highlight the need for targeting high-risk groups, particularly smokers, for targeted interventions and education to improve postpartum screening in communities of socioeconomic disadvantage. Addressing these barriers may improve early identification of women with type II diabetes following GDM and improve long-term maternal health outcomes.