Changes in postpartum glucose testing behaviors after the implementation of a gestational diabetes mellitus screening policy

On July 1, 2021, Taiwan implemented a national policy incorporating gestational diabetes mellitus (GDM) screening into routine prenatal care and adopted a standardized 75-g oral glucose tolerance test (OGTT). This initiative aimed to normalize prenatal GDM screening; however, its impact on postpartum glucose testing behaviors remains uncertain. We assessed changes in postpartum glucose testing after policy implementation.

This retrospective cohort study used data from the Taiwan National Health Insurance Research Database. We compared maternal records from 1.5 years before policy implementation (January 1, 2020-June 30, 2021) with those from 1.5 years after implementation (July 1, 2021-December 31, 2022). Outcomes included postpartum glucose testing, timing of testing, and follow-up specialty.

After policy implementation, the proportion of women who received postpartum glucose testing within 3 months of delivery increased by 12.10 percentage points. Testing shifted toward the first 3 months postpartum (overall χ² (df = 2) = 53.83; p < 0.0001). Follow-up in obstetrics and gynecology increased by 3.02 percentage points, and follow-up in endocrinology increased by 1.74 percentage points (both p < 0.0001).

After GDM screening was incorporated into routine prenatal care, postpartum glucose testing occurred earlier and became more concentrated, with postpartum follow-up more frequently occurring in obstetrics and gynecology and endocrinology. Even in the absence of a specific intervention targeting postpartum glucose testing, changes in postpartum testing behavior were observed, suggesting a spillover effect from the integration of GDM screening into routine prenatal care.