The analysis of the influencing factors and countermeasures of postpartum loss to follow-up of women with gestational diabetes mellitus / 中国实用护理杂志

ABSTRACT

Objectives:To explore the related factors that influence the postpartum loss to follow-up of women with gestational diabetes mellitus and the corresponding countermeasures to improve management of postpartum loss to follow-up in order to improve its rate.Methods:A total of 212 patients were selected from women diagnosed with gestational diabetes before delivery in Women′s Hospital School of Medicine Zhejiang University between December, 2018 and March, 2019. These patients were reminded by hospital education and telephone call-back and followed up by questionnaire at 12 weeks after delivery. The rates of follow up and the rate of postpartum blood glucose screening after delivery were calculated. The demographic and social data, clinical data during pregnancy and delivery, and postpartum blood glucose screening were compared between the follow-up group and the group of loss to follow up. The group of loss to follow up was contacted by telephone to inquiry the reason of loss.Results:Totally 159 out of 212 cases completed postpartum follow-up with the rate of 75.00% (159/212) and the loss rate was 25.00% (53/212). 52 cases underwent postpartum blood glucose screening with the rate of 24.53% (52/212), 22.64% (48/212) in the follow-up group and 1.89% (4/212) in the group of loss to follow up. Permanent residence, occupation, monthly family income, medical payment method, obstetric complications, family history, management doctor's own quality, attendance of pregnancy specialist from outpatient service, acceptance of complication propaganda and education, attitude to postpartum follow-up, etc are the influencing factors, the difference was statistically significant ( χ2 value was 4.392-65.328, P<0.01 or 0.05). Conclusion:Women with gestational diabetes mellitus have a high rate of postpartum loss to follow up. Medical personnel should improve their professional quality and strengthen the multidisciplinary and joint management model, establishing a standardized and targeted postpartum follow-up procedure and strengthening the focus of postpartum follow-up education to improve the quality and efficiency of postpartum follow-up management.