Assessing the impact of the COVID-19 pandemic on uptake and experiences of gestational diabetes mellitus screening in Ontario: A parallel convergent mixed-methods study.

<h4>Objective</h4>Gestational diabetes mellitus (GDM) is a common medical complication of pregnancy that leads to adverse outcomes for both infants and pregnant people. Early detection and treatment can mitigate these negative outcomes. The COVID-19 pandemic strained healthcare and labor...

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Main Authors: Dima Hadid, Rebecca H Correia, Sarah D McDonald, Elizabeth K Darling, David Kirkwood, Aaron Jones, Andrea Carruthers, Cassandra Kuyvenhoven, Michelle Howard, Devon Greyson, Sujane Kandasamy, Meredith Vanstone
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0315983
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author Dima Hadid
Rebecca H Correia
Sarah D McDonald
Elizabeth K Darling
David Kirkwood
Aaron Jones
Andrea Carruthers
Cassandra Kuyvenhoven
Michelle Howard
Devon Greyson
Sujane Kandasamy
Meredith Vanstone
author_facet Dima Hadid
Rebecca H Correia
Sarah D McDonald
Elizabeth K Darling
David Kirkwood
Aaron Jones
Andrea Carruthers
Cassandra Kuyvenhoven
Michelle Howard
Devon Greyson
Sujane Kandasamy
Meredith Vanstone
author_sort Dima Hadid
collection DOAJ
description <h4>Objective</h4>Gestational diabetes mellitus (GDM) is a common medical complication of pregnancy that leads to adverse outcomes for both infants and pregnant people. Early detection and treatment can mitigate these negative outcomes. The COVID-19 pandemic strained healthcare and laboratory services, including GDM screening programs. Adapted GDM screening guidelines were introduced in many jurisdictions. This study examined changes in uptake, modality, and experiences of GDM screening in Ontario, Canada during the COVID-19 pandemic.<h4>Methods</h4>This convergent mixed-method study involved a population-based retrospective cohort analysis of Ontario-based health administrative data to describe and compare gestational diabetes screening rates among 85,228 individuals with live, in-hospital births between January 1-March 31 before (2019) and during the COVID-19 pandemic (2021 and 2022). Descriptive analyses were conducted for GDM screening pathways aligning with usual and pandemic-adapted screening guidance. Qualitative descriptive interviews were conducted about experiences and decision-making of GDM screening with 43 Ontario residents who gave birth between May 2020 and December 2021. Data were integrated during the design and interpretation phases.<h4>Results</h4>There were small but significant increases in GDM screening during the pandemic; likelihood of screening completion using any modality increased in 2021 and 2022 compared to 2019. Testing modality shifted; the alternate screening strategies introduced during COVID-19 were adopted by clinicians. Interview participants perceived GDM screening to be important and obligatory but accompanied by a degree of stress about potential COVID-19 exposure.<h4>Conclusion</h4>Despite health system challenges experienced in Ontario during the COVID-19 pandemic, GDM screening rates increased in the study population, demonstrating the success of adapted GDM screening guidelines. Decisions about screening modalities were driven by clinician expertise, and interview participants were satisfied to provide informed consent to these recommendations.
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spelling doaj-art-fda8950f757946b69ec97cd50542b7d92025-01-08T05:32:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011912e031598310.1371/journal.pone.0315983Assessing the impact of the COVID-19 pandemic on uptake and experiences of gestational diabetes mellitus screening in Ontario: A parallel convergent mixed-methods study.Dima HadidRebecca H CorreiaSarah D McDonaldElizabeth K DarlingDavid KirkwoodAaron JonesAndrea CarruthersCassandra KuyvenhovenMichelle HowardDevon GreysonSujane KandasamyMeredith Vanstone<h4>Objective</h4>Gestational diabetes mellitus (GDM) is a common medical complication of pregnancy that leads to adverse outcomes for both infants and pregnant people. Early detection and treatment can mitigate these negative outcomes. The COVID-19 pandemic strained healthcare and laboratory services, including GDM screening programs. Adapted GDM screening guidelines were introduced in many jurisdictions. This study examined changes in uptake, modality, and experiences of GDM screening in Ontario, Canada during the COVID-19 pandemic.<h4>Methods</h4>This convergent mixed-method study involved a population-based retrospective cohort analysis of Ontario-based health administrative data to describe and compare gestational diabetes screening rates among 85,228 individuals with live, in-hospital births between January 1-March 31 before (2019) and during the COVID-19 pandemic (2021 and 2022). Descriptive analyses were conducted for GDM screening pathways aligning with usual and pandemic-adapted screening guidance. Qualitative descriptive interviews were conducted about experiences and decision-making of GDM screening with 43 Ontario residents who gave birth between May 2020 and December 2021. Data were integrated during the design and interpretation phases.<h4>Results</h4>There were small but significant increases in GDM screening during the pandemic; likelihood of screening completion using any modality increased in 2021 and 2022 compared to 2019. Testing modality shifted; the alternate screening strategies introduced during COVID-19 were adopted by clinicians. Interview participants perceived GDM screening to be important and obligatory but accompanied by a degree of stress about potential COVID-19 exposure.<h4>Conclusion</h4>Despite health system challenges experienced in Ontario during the COVID-19 pandemic, GDM screening rates increased in the study population, demonstrating the success of adapted GDM screening guidelines. Decisions about screening modalities were driven by clinician expertise, and interview participants were satisfied to provide informed consent to these recommendations.https://doi.org/10.1371/journal.pone.0315983
spellingShingle Dima Hadid
Rebecca H Correia
Sarah D McDonald
Elizabeth K Darling
David Kirkwood
Aaron Jones
Andrea Carruthers
Cassandra Kuyvenhoven
Michelle Howard
Devon Greyson
Sujane Kandasamy
Meredith Vanstone
Assessing the impact of the COVID-19 pandemic on uptake and experiences of gestational diabetes mellitus screening in Ontario: A parallel convergent mixed-methods study.
PLoS ONE
title Assessing the impact of the COVID-19 pandemic on uptake and experiences of gestational diabetes mellitus screening in Ontario: A parallel convergent mixed-methods study.
title_full Assessing the impact of the COVID-19 pandemic on uptake and experiences of gestational diabetes mellitus screening in Ontario: A parallel convergent mixed-methods study.
title_fullStr Assessing the impact of the COVID-19 pandemic on uptake and experiences of gestational diabetes mellitus screening in Ontario: A parallel convergent mixed-methods study.
title_full_unstemmed Assessing the impact of the COVID-19 pandemic on uptake and experiences of gestational diabetes mellitus screening in Ontario: A parallel convergent mixed-methods study.
title_short Assessing the impact of the COVID-19 pandemic on uptake and experiences of gestational diabetes mellitus screening in Ontario: A parallel convergent mixed-methods study.
title_sort assessing the impact of the covid 19 pandemic on uptake and experiences of gestational diabetes mellitus screening in ontario a parallel convergent mixed methods study
url https://doi.org/10.1371/journal.pone.0315983
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