Changes in postpartum glucose testing behaviors after the implementation of a gestational diabetes mellitus screening policy

OBJECTIVE: On July 1, 2021, Taiwan implemented a national policy incorporating gestational diabetes mellitus (GDM) screening into routine prenatal care and adopted a standardized 75-g oral glucose tolerance test (OGTT). This initiative aimed to normalize prenatal GDM screening; however, its impact on postpartum glucose testing behaviors remains uncertain. We assessed changes in postpartum glucose testing after policy implementation. MATERIALS AND METHODS: This retrospective cohort study used data from the Taiwan National Health Insurance Research Database. We compared maternal records from 1.5 years before policy implementation (January 1, 2020-June 30, 2021) with those from 1.5 years after implementation (July 1, 2021-December 31, 2022). Outcomes included postpartum glucose testing, timing of testing, and follow-up specialty. RESULTS: (df = 2) = 53.83; p < 0.0001). Follow-up in obstetrics and gynecology increased by 3.02 percentage points, and follow-up in endocrinology increased by 1.74 percentage points (both p < 0.0001). CONCLUSION: After GDM screening was incorporated into routine prenatal care, postpartum glucose testing occurred earlier and became more concentrated, with postpartum follow-up more frequently occurring in obstetrics and gynecology and endocrinology. Even in the absence of a specific intervention targeting postpartum glucose testing, changes in postpartum testing behavior were observed, suggesting a spillover effect from the integration of GDM screening into routine prenatal care.