Barriers and facilitators to attending postpartum diabetes screening among women with previous gestational diabetes in China: A qualitative analysis.

Abstract

Introduction: Gestational diabetes mellitus (GDM) is a common complication of pregnancy associated with a higher risk of developing type 2 diabetes (T2DM) in the future. Postpartum diabetes screening is important to identify glucose intolerance and introduce diabetes prevention support. However, screening uptake is suboptimal, including in China where the prevalence of GDM is high. There is limited evidence on the barriers and facilitators to screening uptake among Chinese women.

Aims: To explore the barriers and facilitators of postpartum diabetes screening uptake among Chinese women with GDM to inform the development of an intervention to increase screening attendance.

Methods: Women with current or previous GDM were recruited from social network platforms and pregnancy groups in China. Data were collected using semi-structured interviews and analysed using Framework Analysis to identify themes related to the barriers and facilitators for screening uptake.

Results: Twenty-four women with current (n = 4) or previous (n = 20) GDM participated. The postpartum glucose screening attendance rate was 35% among those with previous GDM. Screening uptake was influenced by: risk awareness of T2DM and its complications, interactions with healthcare providers (HCPs), screening-related factors (understanding and beliefs, accessibility and acceptability of the test) and motivation to maintain personal health, which was influenced by fear of T2DM, lack of symptoms, confidence in self management without support, and prioritisation of the child's needs.

Conclusion: Postpartum screening uptake after GDM could be boosted through raising risk awareness, more constructive communication from HCPs, increasing the acceptability and accessibility of screening procedures, and addressing psychological factors related to attendance.