Interventions to increase the uptake of postpartum diabetes screening among women with previous gestational diabetes: a systematic review and Bayesian network meta-analysis

Jing Huang; Rita Forde; Judith Parsons; Xiaoyan Zhao; Jianying Wang; Yingjie Liu; Angus Forbes

doi:10.1016/j.ajogmf.2023.101137

Interventions to increase the uptake of postpartum diabetes screening among women with previous gestational diabetes: a systematic review and Bayesian network meta-analysis

Jing Huang^*, Rita Forde, Judith Parsons, Xiaoyan Zhao, Jianying Wang, Yingjie Liu, Angus Forbes

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

5 Citations (Scopus)

Abstract

OBJECTIVE: This study aimed to summarize the current interventions aimed at improving postpartum diabetes screening attendance and to compare their effectiveness. DATA SOURCES: Literature searches were conducted in the Web of Science, Embase, Cochrane Library, CINAHL, and PubMed from inception to March 20, 2023. STUDY ELIGIBILITY CRITERIA: Quantitative studies involving an intervention to increase postpartum diabetes screening attendance among women with gestational diabetes mellitus were included. METHODS: The Joanna Briggs Institute checklists were used for the quality appraisal of the included studies. A Bayesian network meta-analysis was performed to synthesize the comparative effectiveness of the relevant interventions aimed at improving postpartum diabetes screening rates. RESULTS: A total of 40 studies were included in this review with pooled data from 17,123 women. Studies included randomized controlled trials (n=11, including 3 US-based studies and 8 non-US–based studies) and nonrandomised studies (n=29, including 13 US-based studies and 16 non-US–based studies). Of the 14 studies that reported screening outcomes, 11 detected early type 2 diabetes at a rate ranging from 2.0% to 23.0%. The types of interventions identified included reminders (eg, postal letters, emails, and phone messages), educational interventions, screening methods and delivery, policy changes, antenatal groups, and multimodal interventions. Based on the network meta-analysis from randomized controlled trials, antenatal group intervention, which refers to antenatal patient education delivered in groups (1 US-based study), had the highest probability to be the most effective intervention (odds ratio, 10; 95% confidence interval, 1.6–77.0), followed by one-to-one educational intervention with written educational materials or counselling (odds ratio, 6.9; 95% confidence interval, 3.6–16.0). The results from nonrandomized studies indicated that flexible screening methods and delivery (2 US-based studies) had the greatest impact on screening uptake (odds ratio, 3.9; 95% confidence interval, 1.8–10.0), followed by educational interventions (1 US-based study and 2 non-US–based studies) with antenatal patient education and written educational materials (odds ratio, 3.4; 95% confidence interval, 1.9–6.3) and antenatal groups (odds ratio, 3.3; 95% confidence interval, 1.7–6.7). CONCLUSION: The presented evidence suggests that antenatal patient education delivered in groups and offering more flexible screening methods were associated with the greatest increase in attendance. The multimodal interventions and reminders could still be important if they were more theoretically grounded and were more integrated into the healthcare system.

Original language	English
Article number	101137
Journal	American Journal of Obstetrics and Gynecology MFM
Volume	5
Issue number	10
DOIs	https://doi.org/10.1016/j.ajogmf.2023.101137
Publication status	Published - 1 Oct 2023

Keywords

gestational diabetes
interventions
network meta-analysis
postpartum diabetes screening
type 2 diabetes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.ajogmf.2023.101137

Cite this

Huang, J., Forde, R., Parsons, J., Zhao, X., Wang, J., Liu, Y., & Forbes, A. (2023). Interventions to increase the uptake of postpartum diabetes screening among women with previous gestational diabetes: a systematic review and Bayesian network meta-analysis. American Journal of Obstetrics and Gynecology MFM, 5(10), Article 101137. https://doi.org/10.1016/j.ajogmf.2023.101137

@article{835997b5c37542e6967e56bb8c49ce35,

title = "Interventions to increase the uptake of postpartum diabetes screening among women with previous gestational diabetes: a systematic review and Bayesian network meta-analysis",

abstract = "OBJECTIVE: This study aimed to summarize the current interventions aimed at improving postpartum diabetes screening attendance and to compare their effectiveness. DATA SOURCES: Literature searches were conducted in the Web of Science, Embase, Cochrane Library, CINAHL, and PubMed from inception to March 20, 2023. STUDY ELIGIBILITY CRITERIA: Quantitative studies involving an intervention to increase postpartum diabetes screening attendance among women with gestational diabetes mellitus were included. METHODS: The Joanna Briggs Institute checklists were used for the quality appraisal of the included studies. A Bayesian network meta-analysis was performed to synthesize the comparative effectiveness of the relevant interventions aimed at improving postpartum diabetes screening rates. RESULTS: A total of 40 studies were included in this review with pooled data from 17,123 women. Studies included randomized controlled trials (n=11, including 3 US-based studies and 8 non-US–based studies) and nonrandomised studies (n=29, including 13 US-based studies and 16 non-US–based studies). Of the 14 studies that reported screening outcomes, 11 detected early type 2 diabetes at a rate ranging from 2.0% to 23.0%. The types of interventions identified included reminders (eg, postal letters, emails, and phone messages), educational interventions, screening methods and delivery, policy changes, antenatal groups, and multimodal interventions. Based on the network meta-analysis from randomized controlled trials, antenatal group intervention, which refers to antenatal patient education delivered in groups (1 US-based study), had the highest probability to be the most effective intervention (odds ratio, 10; 95% confidence interval, 1.6–77.0), followed by one-to-one educational intervention with written educational materials or counselling (odds ratio, 6.9; 95% confidence interval, 3.6–16.0). The results from nonrandomized studies indicated that flexible screening methods and delivery (2 US-based studies) had the greatest impact on screening uptake (odds ratio, 3.9; 95% confidence interval, 1.8–10.0), followed by educational interventions (1 US-based study and 2 non-US–based studies) with antenatal patient education and written educational materials (odds ratio, 3.4; 95% confidence interval, 1.9–6.3) and antenatal groups (odds ratio, 3.3; 95% confidence interval, 1.7–6.7). CONCLUSION: The presented evidence suggests that antenatal patient education delivered in groups and offering more flexible screening methods were associated with the greatest increase in attendance. The multimodal interventions and reminders could still be important if they were more theoretically grounded and were more integrated into the healthcare system.",

keywords = "gestational diabetes, interventions, network meta-analysis, postpartum diabetes screening, type 2 diabetes",

author = "Jing Huang and Rita Forde and Judith Parsons and Xiaoyan Zhao and Jianying Wang and Yingjie Liu and Angus Forbes",

note = "Funding Information: J.H. was supported by the King's College London-China Scholarship Council Scholarship (K-CSC scholarship). Publisher Copyright: {\textcopyright} 2023 The Author(s)",

year = "2023",

month = oct,

day = "1",

doi = "10.1016/j.ajogmf.2023.101137",

language = "English",

volume = "5",

journal = "American Journal of Obstetrics and Gynecology MFM",

issn = "2589-9333",

publisher = "Elsevier BV",

number = "10",

}

Huang, J , Forde, R , Parsons, J , Zhao, X, Wang, J, Liu, Y & Forbes, A 2023, 'Interventions to increase the uptake of postpartum diabetes screening among women with previous gestational diabetes: a systematic review and Bayesian network meta-analysis', American Journal of Obstetrics and Gynecology MFM, vol. 5, no. 10, 101137. https://doi.org/10.1016/j.ajogmf.2023.101137

Interventions to increase the uptake of postpartum diabetes screening among women with previous gestational diabetes: a systematic review and Bayesian network meta-analysis. / Huang, Jing ; Forde, Rita ; Parsons, Judith et al.
In: American Journal of Obstetrics and Gynecology MFM, Vol. 5, No. 10, 101137, 01.10.2023.

Research output: Contribution to journal › Review article › peer-review

TY - JOUR

T1 - Interventions to increase the uptake of postpartum diabetes screening among women with previous gestational diabetes

T2 - a systematic review and Bayesian network meta-analysis

AU - Huang, Jing

AU - Forde, Rita

AU - Parsons, Judith

AU - Zhao, Xiaoyan

AU - Wang, Jianying

AU - Liu, Yingjie

AU - Forbes, Angus

PY - 2023/10/1

Y1 - 2023/10/1

N2 - OBJECTIVE: This study aimed to summarize the current interventions aimed at improving postpartum diabetes screening attendance and to compare their effectiveness. DATA SOURCES: Literature searches were conducted in the Web of Science, Embase, Cochrane Library, CINAHL, and PubMed from inception to March 20, 2023. STUDY ELIGIBILITY CRITERIA: Quantitative studies involving an intervention to increase postpartum diabetes screening attendance among women with gestational diabetes mellitus were included. METHODS: The Joanna Briggs Institute checklists were used for the quality appraisal of the included studies. A Bayesian network meta-analysis was performed to synthesize the comparative effectiveness of the relevant interventions aimed at improving postpartum diabetes screening rates. RESULTS: A total of 40 studies were included in this review with pooled data from 17,123 women. Studies included randomized controlled trials (n=11, including 3 US-based studies and 8 non-US–based studies) and nonrandomised studies (n=29, including 13 US-based studies and 16 non-US–based studies). Of the 14 studies that reported screening outcomes, 11 detected early type 2 diabetes at a rate ranging from 2.0% to 23.0%. The types of interventions identified included reminders (eg, postal letters, emails, and phone messages), educational interventions, screening methods and delivery, policy changes, antenatal groups, and multimodal interventions. Based on the network meta-analysis from randomized controlled trials, antenatal group intervention, which refers to antenatal patient education delivered in groups (1 US-based study), had the highest probability to be the most effective intervention (odds ratio, 10; 95% confidence interval, 1.6–77.0), followed by one-to-one educational intervention with written educational materials or counselling (odds ratio, 6.9; 95% confidence interval, 3.6–16.0). The results from nonrandomized studies indicated that flexible screening methods and delivery (2 US-based studies) had the greatest impact on screening uptake (odds ratio, 3.9; 95% confidence interval, 1.8–10.0), followed by educational interventions (1 US-based study and 2 non-US–based studies) with antenatal patient education and written educational materials (odds ratio, 3.4; 95% confidence interval, 1.9–6.3) and antenatal groups (odds ratio, 3.3; 95% confidence interval, 1.7–6.7). CONCLUSION: The presented evidence suggests that antenatal patient education delivered in groups and offering more flexible screening methods were associated with the greatest increase in attendance. The multimodal interventions and reminders could still be important if they were more theoretically grounded and were more integrated into the healthcare system.

AB - OBJECTIVE: This study aimed to summarize the current interventions aimed at improving postpartum diabetes screening attendance and to compare their effectiveness. DATA SOURCES: Literature searches were conducted in the Web of Science, Embase, Cochrane Library, CINAHL, and PubMed from inception to March 20, 2023. STUDY ELIGIBILITY CRITERIA: Quantitative studies involving an intervention to increase postpartum diabetes screening attendance among women with gestational diabetes mellitus were included. METHODS: The Joanna Briggs Institute checklists were used for the quality appraisal of the included studies. A Bayesian network meta-analysis was performed to synthesize the comparative effectiveness of the relevant interventions aimed at improving postpartum diabetes screening rates. RESULTS: A total of 40 studies were included in this review with pooled data from 17,123 women. Studies included randomized controlled trials (n=11, including 3 US-based studies and 8 non-US–based studies) and nonrandomised studies (n=29, including 13 US-based studies and 16 non-US–based studies). Of the 14 studies that reported screening outcomes, 11 detected early type 2 diabetes at a rate ranging from 2.0% to 23.0%. The types of interventions identified included reminders (eg, postal letters, emails, and phone messages), educational interventions, screening methods and delivery, policy changes, antenatal groups, and multimodal interventions. Based on the network meta-analysis from randomized controlled trials, antenatal group intervention, which refers to antenatal patient education delivered in groups (1 US-based study), had the highest probability to be the most effective intervention (odds ratio, 10; 95% confidence interval, 1.6–77.0), followed by one-to-one educational intervention with written educational materials or counselling (odds ratio, 6.9; 95% confidence interval, 3.6–16.0). The results from nonrandomized studies indicated that flexible screening methods and delivery (2 US-based studies) had the greatest impact on screening uptake (odds ratio, 3.9; 95% confidence interval, 1.8–10.0), followed by educational interventions (1 US-based study and 2 non-US–based studies) with antenatal patient education and written educational materials (odds ratio, 3.4; 95% confidence interval, 1.9–6.3) and antenatal groups (odds ratio, 3.3; 95% confidence interval, 1.7–6.7). CONCLUSION: The presented evidence suggests that antenatal patient education delivered in groups and offering more flexible screening methods were associated with the greatest increase in attendance. The multimodal interventions and reminders could still be important if they were more theoretically grounded and were more integrated into the healthcare system.

KW - gestational diabetes

KW - interventions

KW - network meta-analysis

KW - postpartum diabetes screening

KW - type 2 diabetes

UR - http://www.scopus.com/inward/record.url?scp=85170674655&partnerID=8YFLogxK

U2 - 10.1016/j.ajogmf.2023.101137

DO - 10.1016/j.ajogmf.2023.101137

M3 - Review article

C2 - 37619781

AN - SCOPUS:85170674655

SN - 2589-9333

VL - 5

JO - American Journal of Obstetrics and Gynecology MFM

JF - American Journal of Obstetrics and Gynecology MFM

IS - 10

M1 - 101137

ER -

Interventions to increase the uptake of postpartum diabetes screening among women with previous gestational diabetes: a systematic review and Bayesian network meta-analysis

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this