Screening of diabetes in pregnancy in New Zealand: translation of national guidelines into practice.

Aim: To evaluate the proportion of pregnant women who completed screening for pre-existing diabetes and GDM, following publication of the Guideline.

Methods: A stocktake was conducted of clinical audits by University of Auckland medical students in nine New Zealand public hospitals between 2015 and 2021. Audits were included if they investigated whether women who gave birth were screened for diabetes in pregnancy according to Guideline recommendations.

Results: Nineteen audits of 3213 women investigated the screening rates for (1) pre-existing diabetes, by 20 weeks' gestation, using HbA1c [n=16]); (2) oral glucose tolerance test, OGTT, follow up of abnormal HbA1c at 24-28 weeks' [n=4]); (3) glucose challenge test, GCT, at 24-28 weeks' [n=9]); and (4) OGTT follow-up of abnormal GCT [n=10]). There was improvement in HbA1c screening, from 28% in 2015 to 84% in 2020. OGTT testing rates were high in all audits. Māori had lower rates of screening for GDM (standards 2 & 3) than non-Māori (62% versus 86%, p<0.05; 3 audits, n=837).

Conclusions: The national guideline made a positive contribution to the quality of care provided, however, further targeted interventions need to be implemented to meet the standard of care, especially for Māori women.