Poster Presentation ESA-SRB-ANZBMS 2024 in conjunction with ENSA

IMPACT OF PCOS GUIDELINE ON PRECONCEPTION AND GESTATIONAL DIABETES SCREENING (#564)

Chau Thien Tay 1 2 , Parneet Sethi 1 , Deborah Loxton 3 , Helena Teede 1 2 , Anju Joham 1 2
  1. Monash Centre for Health Research and Implementation, Clayton, VIC, Australia
  2. Department of Diabetes and Vascular Medicine, Monash Health, Clayton, VIC, Australia
  3. Research Centre for Generational Health and Ageing, University of Newcastle, Callaghan, New South Wales, Australia

Aims:
Assess the impact of the 2018 International PCOS Guideline on preconception dysglycaemia and early gestational diabetes mellitus (GDM) screening in Australia.

Methods:
Data from the Australian Longitudinal Study on Women's Health and the Medicare Benefits Schedule (MBS) were used. Women with verified pregnancy outcomes in the MBS database were included. Dysglycaemia testing was identified via MBS codes. Preconception screening involved tests within a year before conception, and early GDM screening involved oral glucose tolerance tests before 24 weeks of gestation. The pre-guideline period was from August 1, 2016, to July 31, 2018, and the post-guideline period from August 1, 2019, to July 31, 2021. Logistic regression analysis, adjusted for maternal age and state of residence, explored the association between guideline publication and screening practices.

Results:
Data were from 714 women (756 pregnancies) pre-guideline and 727 women (776 pregnancies) post-guideline. The prevalence of PCOS was 13%. Preconception screening rates in women with PCOS were 9% before the guideline and 10% after, with no significant difference. Early GDM screening rates were higher in pregnancies of women with PCOS than those without, both before (21% vs. 11%, p<0.05) and after (18% vs. 10%, p<0.05) guideline publication. However, the change in early GDM testing rates for women with PCOS before and after the guideline was not statistically significant. Logistic regression, adjusted for maternal age and state of residence, showed no significant association between guideline publication and screening rates.

Conclusion:
While awareness of GDM risk in women with PCOS is reflected in higher early GDM screening rates, the 2018 International PCOS Guideline did not improve preconception dysglycaemia or early GDM screening rates among Australian women with PCOS. This indicates a gap between guideline recommendations and clinical practice, highlighting the need to enhance adherence to guideline-recommended screening practices to optimize outcomes for this high-risk population.