RT Journal Article SR Electronic T1 Uptake of guideline-recommended postpartum diabetes screening among diverse women with gestational diabetes: associations with patient factors in an integrated health system in the USA JF BMJ Open Diabetes Research & Care JO BMJ Open Diab Res Care FD American Diabetes Association SP e002726 DO 10.1136/bmjdrc-2021-002726 VO 10 IS 3 A1 Susan D Brown A1 Monique M Hedderson A1 Yeyi Zhu A1 Ai-Lin Tsai A1 Juanran Feng A1 Charles P Quesenberry A1 Assiamira Ferrara YR 2022 UL http://drc.bmj.com/content/10/3/e002726.abstract AB Introduction Clinical guidelines urge timely postpartum screening for diabetes among women with gestational diabetes mellitus (GDM), yet patient factors associated with screening uptake remain unclear. We aimed to identify patient factors associated with completed postpartum diabetes screening (2-hour oral glucose tolerance test within 4–12 weeks postpartum), as recommended by the American Diabetes Association (ADA).Research design and methods Within the context of Gestational Diabetes’ Effects on Moms (GEM), a pragmatic cluster randomized trial (2011–2012), we examined survey and electronic health record data to assess clinical and sociodemographic factors associated with uptake of ADA-recommended postpartum screening. Participants included 1642 women (76% racial/ethnic minorities) identified with GDM according to the Carpenter and Coustan criteria in a health system that deploys population-level strategies to promote screening. To contextualize these analyses, screening rates derived from the GEM trial were compared with those in the health system overall using registry data from a concurrent 10-year period (2007–2016, n=21 974).Results Overall 52% (n=857) completed recommended postpartum screening in the analytic sample, comparable to 45.7% (n=10 040) in the registry. Screening in the analytic sample was less likely among women at elevated risk for type 2 diabetes, assessed using items from an ADA risk test (vs non-elevated; adjusted rate ratio (aRR)=0.86 (95% CI 0.75 to 0.98)); perinatal depression (0.88 (0.79 to 0.98)); preterm delivery (0.84 (0.72 to 0.98)); parity ≥2 children (vs 0; 0.80 (0.69 to 0.93)); or less than college education (0.79 (0.72 to 0.86)). Screening was more likely among Chinese Americans (vs White; 1.31 (1.15 to 1.49)); women who attended a routine postpartum visit (5.28 (2.99 to 9.32)); or women who recalled receiving healthcare provider advice about screening (1.31 (1.03 to 1.67)).Conclusions Guideline-recommended postpartum diabetes screening varied by patient clinical and sociodemographic factors. Findings have implications for developing future strategies to improve postpartum care.Data are available on reasonable request. Deidentified data from this study can be made available to qualified researchers by emailing AF and the corresponding author SDB, subject to approval by the Kaiser Foundation Research Institute Human Subjects Committee and by the Human Subjects Committee at the institution requesting the data, and a signed data sharing agreement.