Dr Lynne Chepulis.

Abstract

Diabetes in pregnancy (DiP) is associated with complications for both mother and child, and current statistics suggest that 1 in 11 pregnancies in New Zealand are affected, including a disproportionate number of Māori. However, until recently in New Zealand screening for DiP has varied widely in opinion and practice, and current recommended guidelines are complicated with multiple steps, such that little is currently known about the adherence to these guidelines, nor what the barriers / enablers are that prevent / allow for screening and timely diagnosis.

To address the lack of DiP screening consistency within New Zealand, the Ministry of Health implemented new guidelines for the screening and diagnosis of DiP in 2014. To date, little is known about how well these guidelines are being adhered to, though a pilot study in the Waikato from 2017 indicated that only 25% of women were being screened according to the Ministry of Health screening pathway, with rates of screening much lower in Māori than in non-Māori women. In order to improve access to screening, more work is needed to understand what the enablers are, and what the barriers are to screening inside of these Ministry of Health timeframes, or indeed, to screening for DiP at any point during their pregnancy.

This study aims to comprehensively evaluate screening for DiP in Waikato women using a cohort of up to 5000 women who birthed during 2018, along with a series of semi-structured interviews with women and healthcare providers about their screening knowledge and experience.