Background
Methods
Search strategy
Study selection, eligibility criteria and data abstraction
Results
Search outcome
Article | Country | Study design | Study population | Focus |
---|---|---|---|---|
Blatt et al. (2011) [23] | USA | Review of data from Quest Diagnostics | 924,873 pregnant women | Characteristics of pregnant women |
Cullinan et al. (2012a) [24] | Ireland | Hospital clinical data | 9,842 pregnant women | Characteristics of the pregnant women |
Cullinan et al. (2012b) [25] | Ireland | Hospital clinical data | 4,414 pregnant women | Characteristics of the pregnant women |
Gazmararian et al. (1996) [19] | USA | Review of prenatal care records | 2,184 pregnant women | Characteristics of health care providers |
Characteristics of the pregnant women | ||||
Landon et al. (1990) [16] | USA | Cross-sectional mail survey | 471 obstetricians and maternal-fetal specialists | Characteristics of health care providers |
Marrero et al. (1992) [17] | USA | Mail survey | 668 family practice physicians and obstetricians/gynaecologists | Characteristics of health care providers |
Moses et al. (2003) [21] | Australia | Review of medical records | 1,648 pregnant women | Characteristics of health care setting |
Nielsen et al. (2012) [15] | Various developing countries | Qualitative. Interviews and questionnaire. | 10 GDM project implementers | Barriers mentioned by project implementers |
Pedula et al. (2009) [26] | USA | Review of medical records | 21,758 pregnancies | Characteristics of the pregnant women |
Ruengkhachorn (2006) [20] | Thailand | Review of antenatal care records | 159 pregnant women | Characteristics of health care setting |
Characteristics of the pregnant women | ||||
Sievenpiper et al. (2012) [18] | Canada | Audit | 1,026 pregnant women | Characteristics of health care providers |
Characteristics of the pregnant women | ||||
Yapa & Simmons (2000) [22] | New Zealand | Review of hospital medical records | 4,885 pregnant women | Characteristics of the pregnant woman |
Article | Country | Study design | Study population | Focus |
---|---|---|---|---|
Bandyopadhyay et al. (2011) [29] | Australia | Qualitative. Semi-structured interviews. | 17 women with GDM | Experiences of living with GDM |
Barriers mentioned by women with GDM | ||||
Collier et al. (2011) [39] | USA | Qualitative. Focus group discussions. | 4 focus group discussion with women with GDM | Barriers mentioned by women with GDM |
Doran & Davis (2010) [30] | Tonga | Qualitative. Semi-structured interviews | 11 women with GDM | Experiences of living with GDM |
Barriers mentioned by health care providers | ||||
Barriers mentioned by women with GDM | ||||
Evans & O’Brien (2005) [31] | Canada | Qualitative. Interviews | 12 women with GDM | Experiences of living with GDM |
Barriers mentioned by women with GDM | ||||
Hirst et al. (2012) [38] | Vietnam | Qualitative. Focus group discussions | 4 focus group discussions with women with GDM | Experiences of living with GDM |
Barriers mentioned by women with GDM | ||||
Hjelm et al. (2007) [36] | Sweden | Qualitative. Semi-structured interviews | 27 women with GDM | Experiences of living with GDM |
Barriers mentioned by women with GDM | ||||
Hjelm et al. (2008) [37] | Sweden | Qualitative. Semi-structured interviews | 23 women with GDM | Experiences of living with GDM |
Barriers mentioned by women with GDM | ||||
Landon et al. (1990) [16] | USA | Cross-sectional mail survey | 471 obstetricians and maternal-fetal specialists | Characteristics of health care providers |
Lawson & Rajaram (1994) [32] | USA | Qualitative. Interviews | 17 women with GDM | Experiences of living with GDM |
Barriers mentioned by women with GDM | ||||
Marrero et al. (1992) [17] | USA | Mail survey | 668 family practice physicians and obstetricians/gynaecologists | Characteristics of health care providers |
Mersereau et al. (2011) [40] | USA | Qualitative. Focus group discussions | 6 focus groups with health care providers | Barriers mentioned by health care providers |
Neufeld (2011) [33] | Canada | Qualitative. Semi-structured interviews | 29 women with GDM | Experiences of living with GDM |
Barriers mentioned by women with GDM | ||||
Persily (1996) [35] | USA | Convenience sample of women with GDM followed from diagnosis through delivery | 29 women with GDM | Experiences of living with GDM |
Persson et al. (2010) [34] | Sweden | Qualitative. Interviews | 10 women with GDM | Experiences of living with GDM |
Barriers mentioned by women with GDM | ||||
Ruggiero et al. (1990) [28] | USA | Cross-sectional survey | 98 women with GDM | Role of psychosocial factors |
Article | Country | Study design | Study population | Focus |
---|---|---|---|---|
Almario et al. (2008) [41] | USA | Review of data from Laboratory Corporation of America and Quest Diagnostics | 90 women with GDM | Characteristics of health care setting |
Characteristics of services/treatment received | ||||
Characteristics of women with GDM | ||||
Baker et al. (2009) [48] | USA | Mail survey | 399 health care providers | Characteristics of health care providers |
Barriers mentioned by health care providers | ||||
Bandyopadhyay et al. (2011) [29] | Australia | Qualitative. Semi-structured interviews. | 17 women with GDM | Experiences of living with GDM |
Barriers mentioned by women with GDM | ||||
Beischer et al. (1997) [47] | Australia | Cohort study using data from GDM follow-up programme | 2,939 women with GDM | Characteristics of health care setting |
Characteristics of services/treatment received | ||||
Characteristics of women with GDM | ||||
Bennett et al. (2011) [61] | USA | Qualitative. Semi-structured interviews. | 22 women with GDM | Barriers mentioned by women with GDM |
Blatt et al. (2011) [23] | USA | Review of data from Quest Diagnostics | 40,955 women with GDM | Characteristics of women with GDM |
Clark et al. (2009) [55] | Canada | Randomized controlled trial | 223 women with GDM | Characteristics of services/treatment received |
Dietz et al. (2008) [46] | USA | Kaiser Permanente Northwest data | 461 women with GDM for first part of the study and 356 for second part. | Characteristics of health care setting |
Characteristics of services/treatment received | ||||
Characteristics of women with GDM | ||||
Ferrara et al. (2009) [58] | USA | Review of medical records | 14,448 women with GDM | Characteristics of women with GDM |
Characteristics of services/treatment received | ||||
Gabbe et al. (2004) [49] | USA | Mail survey | 569 obstetricians/gynaecologists | Characteristics of health care providers |
Graco et al. (2009) [70] | Australia | Qualitative. Interviews | 10 women with GDM | Barriers mentioned by women with GDM |
Hoedjes et al. (2012) [62] | The Netherlands | Qualitative. Focus group discussions | 5 women with GDM | Barriers mentioned by women with GDM |
Hunt & Conway (2008) [59] | USA | Prospective cohort study | 707 women with GDM | Characteristics of women with GDM |
Characteristics of services/treatment received | ||||
Kaufmann et al. (1999) [53] | USA | Cross-sectional survey | 66 women with GDM | Characteristics of health care providers |
Characteristics of women with GDM | ||||
Keely et al. (2010) [50] | Canada | Fax and telephone survey | 173 primary care providers and 140 women with GDM | Barriers mentioned by health care providers |
Barriers mentioned by women with GDM | ||||
Kim et al. (2008) [67] | USA | Cross-sectional survey | 228 women with GDM | Role of psychosocial factors |
Kim et al. (2007) [57] | USA | Cross-sectional survey | 217 women with GDM | Experience of risk of future diabetes |
Kim et al. (2007a) [65] | USA | Cross-sectional survey | 228 women with GDM | Characteristics of services/treatment received |
Kim et al. (2006) [42] | USA | Review of hospital medical records | 533 women with GDM | Characteristics of women with GDM |
Characteristics of health care providers | ||||
Characteristics of services/treatment received | ||||
Koh et al. (2010) [68] | Australia | Cross-sectional telephone survey | 331 women with GDM | Characteristics of women with GDM |
Role of psychosocial factors | ||||
Kwong et al. (2009) [60] | Canada | Retrospective cohort study | 909 women with GDM | Characteristics of women with GDM |
Characteristics of services/treatment received | ||||
Lawrence et al. (2010) [43] | USA | Kaiser Permanente Southern California Medical Care Program data | 11,825 women with GDM | Characteristics of services/treatment received |
Characteristics of women with GDM | ||||
Morrison et al. (2009) [49] | Australia | Cross-sectional mail survey | 1,372 women with GDM | Characteristics of health care providers |
Characteristics of women with GDM | ||||
Characteristics of services/treatment received | ||||
Neufeld (2011) [33] | Canada | Qualitative. Semi-structured interviews | 29 women with GDM | Experiences of living with GDM |
Barriers mentioned by women with GDM | ||||
Nicklas et al. (2011) [71] | USA | Qualitative. Interviews and focus group discussions | 3 focus group discussions with women with GDM, and interviews with 15 women with GDM | Barriers mentioned by women with GDM |
Razee et al. (2010) [72] | Australia | Qualitative. Semi-structured interviews. | 57 women with GDM | Barriers mentioned by women with GDM |
Russell et al. (2006) [54] | USA | Retrospective cohort study | 344 women with GDM | Characteristics of health care setting |
Characteristics of women with GDM | ||||
Shah et al. (2011) [51] | Canada | Population-level health care database | 47,691 women with GDM | Characteristics of health care providers |
Shea et al. (2011) [56] | Canada | Hospital laboratory and provincial physician service claims databases | 262 women with GDM | Characteristics of services/treatment received |
Characteristics of women with GDM | ||||
Smirnakis et al. (2005) [45] | USA | Review of medical records | 197 women with GDM | Characteristics of health care providers |
Characteristics of women with GDM | ||||
Smith et al. (2005) [64] | Australia | Telephone survey | 226 women with GDM | Barriers mentioned by women with GDM |
Role of psychosocial factors | ||||
Stage et al. (2004) [66] | Denmark | Mail survey | 121 women with GDM | Experience of risk of future diabetes |
Stuebe et al. (2010) [52] | USA | Survey | 207 primary care providers and obstetrics & gynaecology care providers | Characteristics of health care providers |
Barriers mentioned by health care providers | ||||
Swan et al. (2007) [69] | Australia | Mail survey | 53 women with GDM | Characteristics of women with GDM |
Symons Downs & Ulbrecht (2006) [73] | USA | Mail survey | 28 women with GDM | Barriers mentioned by women with GDM |
Zehle et al. (2008) [63] | Australia | Telephone survey | 226 women with GDM | Role of psychosocial factors |
Characteristics of women with GDM |
Determinants and barriers for GDM screening
Characteristics of health care providers and health care setting
Client characteristics: ethnicity, body weight and age
Ethnicity
BMI and body weight
Age
Other factors
Barriers for GDM screening
Determinants of and barriers for GDM treatment
Determinants and barriers for postpartum diabetes screening
Characteristics of health care providers and health care setting
Barriers according to health care providers
Characteristics of the client with GDM
Barriers according to women with GDM
Determinants and barriers for healthy postpartum lifestyle and prevention of future diabetes
Barriers for healthy postpartum lifestyle
Discussion
High-income countries | Low- and middle-income countries |
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• No studies focusing on barriers to GDM screening and diagnosis were identified. | • Barriers to GDM screening and diagnosis include difficulties in screening women during the recommended time period, applicability and relevance of the risk factors used in selective screening programmes, challenges in testing women in the fasting state and need for repeat test, screening procedure being too time consuming, scarcity of test consumables and lack of equipment. |
• Barriers to treatment include lack of social support, stress, cost of healthy food, cost of health care and medical supplies, lack of advice and information about diet and exercise, dietary messages being contradictory, dietary messages being difficult to understand, lack of trust in messages received from the health care providers, waiting time to access health care providers for advice, lack of access to health care and health insurance, pregnancy-related food preferences and cravings, diet plans being perceived as stressful, adaptation of unhealthy eating patterns such as bulimia and binging, frequent use of ‘comfort foods’, difficulty in adhering to a diet when participating in social gatherings, concerns for baby’s growth and putting a strain on the baby, reluctance to inject insulin, treatment being time consuming, lack of knowledge, denial of severity, lack of motivation, other social barriers. | • Barriers to treatment include confusion over dietary recommendations, lack of sufficient advice, concerns about the effects of the recommendations, structural changes such as more cars leading to reduced physical activity, more unhealthy take away food options and lower rates of home cooking and eating of traditional foods. |
• Barriers to postpartum screening include health care provider not seeing the patient, the patient being lost to follow-up, lack of communication/collaboration between health care providers, inconsistent guidelines or lack of familiarity to guidelines, not aware about history of GDM, patients not considering the test necessary, or declining testing, or unable to complete test, testing not affordable, patient uninformed or lack understanding of need for test, practice being too busy, time pressure (women), lost requisition, recent delivery experience, baby’s health issues, adjustment to the new baby (emotional stress, feeling overwhelmed and lack of time and burden of child care), concerns about postpartum and future health (feeling healthy and not in need for care, and fear of receiving bad news), and experiences with medical care and services (dissatisfaction with care and logistics of accessing care). | • No studies focusing on barriers to postpartum GDM screening were identified |
• Barriers to healthy postpartum lifestyle include lack of time and/or energy, lack of child care support, not feeling well, emotional distress, lack of motivation, financial barriers, domestic responsibilities such as cooking, lack of knowledge, lack of understanding about GDM, lack of social support, lack of support from health care provider, feeling of solitude, dullness and isolation from family and friends, poor body image, bad weather, considering oneself to be too young to be on a restricted diet, obstacles at work, unsuitable local neighbourhood, no access to exercise equipment, cultural expectations, lack of enjoyment of physical activity, breastfeeding as it made some women increase their food intake. | No studies focusing on barriers to healthy postpartum lifestyle were identified |