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The ADIPS Pilot National Diabetes in Pregnancy Benchmarking Programme
Jincy Immanuel1, Jeff Flack1,2,3, Vincent W Wong3,4
1School of Medicine, Western Sydney University, 2560 Sydney, Australia.
Summary
This study found significant variations in managing pregnancies with hyperglycaemia and their outcomes. Benchmarking care for gestational diabetes mellitus (GDM) and pre-existing diabetes can improve results.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Public Health
Background:
- Pregnancy complicated by hyperglycaemia requires careful management.
- Benchmarking care is essential for improving outcomes in high-risk pregnancies.
Purpose of the Study:
- To assess the feasibility of benchmarking care for pregnancies with hyperglycaemia.
- To identify variations in clinical practices and outcomes across different diabetes services.
Main Methods:
- A retrospective audit of 10,144 pregnancies with hyperglycaemia (gestational diabetes mellitus, type 1 diabetes, type 2 diabetes) from 11 Australian and New Zealand diabetes services (2014-2020).
- Comparison of treatment modalities, birth interventions, and neonatal outcomes across services.
Main Results:
- Significant variations observed in treatment approaches (diet, metformin, insulin) and birth interventions (caesarean rates).
- Wide ranges in adverse outcomes including preterm birth (3.7-9.4%), large for gestational age (10.3-26.7%), special care nursery admission (16.7-25.0%), and neonatal hypoglycaemia (6.0-27.0%).
- Many women with pre-existing diabetes had poor pregnancy planning and first-trimester hyperglycaemia.
Conclusions:
- Management of maternal hyperglycaemia and pregnancy outcomes varied significantly across services.
- Continued benchmarking is crucial for identifying best practices and improving care for women with hyperglycaemia in pregnancy.
Keywords:
HbA1cauditgestational diabetes mellitushealthcare benchmarkingpregnancypregnancy outcomestype 1 diabetes mellitustype 2 diabetes mellitusMore Related Videos
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