PMID- 35098857 OWN - NLM STAT- MEDLINE DCOM- 20221123 LR - 20221123 IS - 1476-4954 (Electronic) IS - 1476-4954 (Linking) VI - 35 IP - 25 DP - 2022 Dec TI - Mother-Infant Dyad program in primary care: evidence-based postpartum care following gestational diabetes. PG - 9336-9341 LID - 10.1080/14767058.2022.2032633 [doi] AB - BACKGROUND: Gestational diabetes mellitus (GDM), a common complication of pregnancy, is associated with a 10-fold increased risk of type 2 diabetes mellitus (T2DM) compared to the general population. Evidence-based guidelines recommend that patients with GDM receive postpartum care for T2DM risk reduction including an oral glucose tolerance test (OGTT) 4-12 weeks after delivery, yet half of patients with GDM did not return for their postpartum visits by 12 weeks postpartum. Additionally, only 10% utilize primary care within 12 months of delivery and one-third of GDM patients receive timely postpartum OGTT. OBJECTIVE: To determine if the Mother-Infant Dyad postpartum primary care program provides a framework to link well-child visits with postpartum primary care visits to increase postpartum clinical interactions promoting longitudinal care, such as postpartum visit attendance and T2DM screening. STUDY DESIGN: All patients with a diagnosis of GDM that received care at a postpartum mother-infant dyad program at a Midwestern academic medical center internal medicine and pediatrics primary care clinic were enrolled. Clinic level data was obtained by baseline and 6-month post-enrollment surveys and chart review. A comparison population was identified from Medicaid claims data using propensity score matching to enable a comparison of program participants' outcomes to a population comprised of similar individuals diagnosed with GDM that received care at sites not participating in the Dyad program. Our primary outcome was completion of T2DM screening in the 4-12 week postpartum period. The secondary outcomes were postpartum visit attendance with a prenatal provider, and prediabetes diagnoses. RESULTS: A total of 75 mother-infant dyads were seen by the clinic. Of the enrolled women, 43% were Non-Hispanic White and 30% were Non-Hispanic Black; mean age was 30.75 years. The matched comparison group (n = 62) had a mean age of 30.75 years, were 43% Non-Hispanic White and 30% Non-Hispanic Black. Women who participated in the program were more likely to receive T2DM screenings than women who did not participate (87 vs. 79%, p<.001) and complete postpartum visits (95 vs. 58%, respectively; p<.001). Additionally, a higher rate of new prediabetes diagnoses was observed (12 vs. 6%, p < .001). CONCLUSION: The Mother-Infant Dyad postpartum primary care program improved T2DM screenings and postpartum visit attendance. In addition, a greater proportion of Dyad program participants experienced new prediabetes diagnoses that those in the comparison group. Our findings suggest that the dyad care model, in which women with GDM engage in postpartum primary care concurrent with well-child visits, can improve longitudinal postpartum care after a GDM diagnosis. FAU - Bose Brill, Seuli AU - Bose Brill S AD - The Ohio State University Wexner Medical Center, Columbus, OH, USA. FAU - May, Sara AU - May S AD - Ohio Colleges of Medicine Government Resource Center, Columbus, OH, USA. FAU - Lorenz, Allison M AU - Lorenz AM AD - Ohio Colleges of Medicine Government Resource Center, Columbus, OH, USA. FAU - Spence, Douglas AU - Spence D AD - Ohio Colleges of Medicine Government Resource Center, Columbus, OH, USA. FAU - Prater, Laura AU - Prater L AD - The Ohio State University Wexner Medical Center, Columbus, OH, USA. FAU - Shellhaas, Cynthia AU - Shellhaas C AD - The Ohio State University Wexner Medical Center, Columbus, OH, USA. AD - Ohio Department of Health, Columbus, OH, USA. FAU - Otsubo, Masami AU - Otsubo M AD - The Ohio State University Wexner Medical Center, Columbus, OH, USA. FAU - Mao, Shengyi AU - Mao S AD - The Ohio State University Wexner Medical Center, Columbus, OH, USA. FAU - Flanigan, Matthew AU - Flanigan M AD - The Ohio State University Wexner Medical Center, Columbus, OH, USA. FAU - Thung, Stephen AU - Thung S AD - The Ohio State University Wexner Medical Center, Columbus, OH, USA. FAU - Leonard, Melissa AU - Leonard M AD - Ohio Colleges of Medicine Government Resource Center, Columbus, OH, USA. FAU - Jiang, Fei AU - Jiang F AD - Ohio Colleges of Medicine Government Resource Center, Columbus, OH, USA. FAU - Oza-Frank, Reena AU - Oza-Frank R AD - Ohio Department of Health, Columbus, OH, USA. LA - eng PT - Journal Article DEP - 20220130 PL - England TA - J Matern Fetal Neonatal Med JT - The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians JID - 101136916 SB - IM MH - Pregnancy MH - Humans MH - Female MH - Child MH - Adult MH - *Diabetes, Gestational/diagnosis/epidemiology/therapy MH - *Prediabetic State MH - *Diabetes Mellitus, Type 2/epidemiology/therapy/diagnosis MH - Postnatal Care MH - Mothers MH - Postpartum Period MH - Primary Health Care OTO - NOTNLM OT - Dyad OT - gestational diabetes mellitus OT - joint care OT - postpartum OT - primary care OT - type 2 diabetes mellitus EDAT- 2022/02/01 06:00 MHDA- 2022/11/24 06:00 CRDT- 2022/01/31 08:42 PHST- 2022/02/01 06:00 [pubmed] PHST- 2022/11/24 06:00 [medline] PHST- 2022/01/31 08:42 [entrez] AID - 10.1080/14767058.2022.2032633 [doi] PST - ppublish SO - J Matern Fetal Neonatal Med. 2022 Dec;35(25):9336-9341. doi: 10.1080/14767058.2022.2032633. Epub 2022 Jan 30.