期刊
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
卷 206, 期 6, 页码 -出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2012.04.019
关键词
gestational diabetes; macrosomia; nurse management; postpartum glucose screening
资金
- Centers for Disease Control and Prevention [U58/CCU523525-03]
- National Institute of Diabetes and Digestive and Kidney Diseases [R18DK067334, K23DK071552]
- Translating Research into Action for Diabetes study
OBJECTIVE: We sought to determine whether, among women with gestational diabetes mellitus, referral to a telephonic nurse management program was associated with lower risk of macrosomia and increased postpartum glucose testing. STUDY DESIGN: There was medical center-level variation in the percent of patients referred to a telephonic nurse management program at 12 Kaiser Permanente medical centers, allowing us to examine in a quasi-experimental design the associations between referral and outcomes. RESULTS: Compared with women from centers where the annual proportion of referral nurse management was <30%, women who delivered from centers with an annual referral proportion >70% were less likely to have a macrosomic infant and more likely to have postpartum glucose testing (multiple-adjusted odds ratio, 0.75; 95% confidence interval, 0.57-0.98 and multiple-adjusted odds ratio, 22.96; 95% confidence interval, 2.56-3.42, respectively). CONCLUSION: Receiving care at the centers with higher referral frequency to telephonic nurse management for gestational diabetes mellitus was associated with decreased risk of macrosomic infant and increased postpartum glucose testing.
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