Gestational diabetes screening changes and impacts on diagnosis
department or school: Medicine, Faculty of
department or school: Population and Public Health (SPPH), School of
data provider: DSpace
degree campus: UBCV
creator: Nethery, Elizabeth M K
issued: 2022-11-16T00:52:31Z
issued: 2022
related degree: Doctor of Philosophy - PhD
degree grantor: University of British Columbia
description: Background: Gestational diabetes mellitus (GDM) affects between 2-40% of pregnancies worldwide, depending on diagnostic and screening methods. Changes in screening practices are not well understood because administrative sources lack data on whether or how individuals were screened. The objectives of this thesis were to: 1) validate a method to identify prenatal screening for GDM and other conditions in administrative health data; 2) describe changes in GDM screening; 3) evaluate the relative contributions of screening and population characteristics to changes in GDM risk; 4) characterize the impact of the COVID-19 pandemic on pregnancy weight gain and infant birthweight. Methods: Laboratory billing records from BC’s universal health insurance system for prenatal screening tests were compared with medical records by calculating validation properties. All pregnancies (birth >20wks or >500g) in British Columbia, Canada, 2005-2019, with linked perinatal health and administrative data, were used to examine time trends in GDM screening methods, trends within subgroups, and the effect of screening changes on prevalence. A second cohort from Washington State, 2016-2020, was analyzed using an interrupted time series design, to assess COVID-19 impacts on pregnancy weight gain and infant birthweight using z-scores. Results: GDM screening in laboratory billing records had a high sensitivity (97% [95% CI: 90, 99]) and specificity (>99% [95% CI: 86, <99]) compared with medical records. GDM diagnoses in BC more than doubled from 7.2% in 2005 to 14.7% in 2019 (n=550,783 pregnancies). Most of this increase was explained by changes in screening; adjustment for population factors had minimal impact. In Washington state, using an interrupted time series, pregnancy weight gain z-score increased by 0.08 (95% CI 0.03, 0.13) after the COVID-19 pandemic onset and infant birthweight z-scores were unchanged (-0.004, 95% CI (-0.04, 0.03)). Conclusion: Prenatal screening tests can be accuratel…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/83112
note: Gestational diabetes screening changes and impacts on diagnosis by Elizabeth M K Nethery B.Ap.Sc., The University of British Columbia, 1998 M.Sc., The University of British Columbia, 2008 M.S.M, Bastyr University, 2014 A DISSERTATION SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Population and Public Health) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) November 2022 © Elizabeth M K Nethery, 2022 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the dissertation entitled: Gestational diabetes screening changes and impacts on diagnosis submitted by Elizabeth M.K. Nethery in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Population and Public Health Examining Committee: Dr. Patricia Janssen, Professor, School of Population and Public Health, UBC Supervisor Dr. Jennifer Hutcheon, Associate Professor, Department of Obstetrics & Gynecology, UBC Supervisory Committee Member Dr. Michael Law, Professor, School of Population and Public Health, UBC Supervisory Committee Member Dr. Geoff Cundiff, Professor, Department of Obstetrics & Gynecology, UBC University Examiner Dr. KS Joseph, Professor, School of Population and Public Health, UBC University Examiner Dr. M Karen Campbell, Professor, Department of Epidemiology and Biostatistics, Western University External Examiner Additional Supervisory Committee Members: Dr. Andrew Kotaska, Assistant Professor, Department of Obstetrics, University of Manitoba Supervisory Committee Member iii ABSTRACT Background: Gestational diabetes mellitus (GDM) affects between 2-40% of pregnancies worldwide, depending on diagnostic and screening methods. Changes in screening practices are not well understood because administrative sources lack data on whether or how individuals were screened. The objectives of this thesis were to…
has type: Thesis/Dissertation
date issued: 2023-05
is shown at: 10.14288/1.0421781
language: eng
degree discipline: Population and Public Health
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
contributor: Janssen, Patricia A.
type: Text
identifier URI: http://hdl.handle.net/2429/83112