Trends in Gestational Diabetes Screening Practices in British Columbia from 2005-2019

Area of Science:

• Reproductive Health
• Endocrinology
• Public Health Policy

Background:

• Gestational diabetes mellitus (GDM) screening practices have evolved with changing clinical guidelines.
• Understanding trends in GDM screening methods is crucial for optimizing maternal care.
• Previous research has not fully captured the shifts in one-step versus two-step GDM screening in British Columbia.

Purpose of the Study:

• To analyze trends in the frequency and method (one-step vs. two-step) of GDM screening in British Columbia.
• To examine GDM screening practices across pregnant individual subgroups and geographic regions.
• To contextualize screening trends within changes in local and national clinical practice guidelines.

Main Methods:

• Retrospective cohort study utilizing linked perinatal and laboratory billing data in British Columbia.
• Inclusion of all pregnancies delivered after 28 weeks gestation with screening dates between June 2004 and May 2019.
• Calculation of screening method prevalence and examination of practices in subgroups and regions relative to guideline changes in 2010 and 2013.

Main Results:

• Overall screening completion increased from 88% to 96% between 2004 and 2019.
• One-step screening use surged to 45.2% after the 2010 guideline change, then slightly decreased to 42.8% post-2013.
• One-step screening was more common in individuals with risk factors and in urban centers, with higher GDM diagnosis rates (18% vs. 9% for two-step).

Conclusions:

• GDM screening in British Columbia shows increased adoption of one-step methods, particularly among higher-risk individuals.
• Significant regional disparities and temporal variations in screening practices persist.
• Further research is needed to address inequities and optimize GDM screening strategies.