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Poster Session 1

Category: Health Equity/Community Health

Poster Session 1

(251) Implementation of an Inpatient 2-hour Glucose Tolerance Test Improves Racial Disparities in Postpartum Screening

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Julia K. Smeal, BS, MD (she/her/hers)

Resident Physician
Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania, United States

Coauthor(s)

EQ

Elizabeth Quigley, DNP, RN

Clinical Director of Women’s Health
Pennsylvania Hospital, University of Pennsylvania
Philadelphia, Pennsylvania, United States
AN

Antoilyn Nguyen, N/A

Undergraduate Student
Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania, United States
Celeste Durnwald, MD (she/her/hers)

Professor, OB/GYN, Maternal Fetal Medicine
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, Pennsylvania, United States
Matthew K. Janssen, MD (he/him/his)

Assistant Professor, Maternal Fetal Medicine
Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania, United States
Rebecca F. Hamm, MD, MSCE (she/her/hers)

Assistant Professor, Maternal Fetal Medicine
Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania, United States

Objective:
Growing evidence supports that implementation of a 2-hour glucose tolerance test (2hGTT) during postpartum (PP) admission in gestational diabetes (GDM) increases adherence without decreasing efficacy. This study aims to determine if implementation of a PP inpatient 2hGTT impacts racial disparities in GTT adherence.

Study Design:
This single-site prospective cohort study compared 1 year before (PRE 2/2023-1/2024) to 1 year after (POST 1/2024-2/2025) implementation of an inpatient 2hGTT performed on PP day 2 for patients with GDM in place of a 6-12 week screen. Patients with GDM were included if they received prenatal care and delivered a live fetus at ≥24 weeks’ gestation in our health system. Self-reported race was divided into Black and non-Black. Primary outcome was rate of GTT adherence within 12 weeks of delivery. PP visit attendance was used as a balancing metric. Multivariable logistic regression assessed for variables associated with exposure (race in PRE/POST groups) and outcome (GTT adherence) as confounders. Interaction terms evaluated for impact of inpatient 2hGTT on disparities in GTT completion by race.

Results:
380 patients were included (PRE=183; POST=197). In the PRE group, there was a statistically significant disparity in rate of 2hGTT adherence, with only 5.4% Black patients completing a GTT vs 23.3% of non-Black patients (p=0.02), which persisted in adjusted analyses (aRR 0.21, 95%CI[0.05-0.93]). No such disparity was seen POST (Black 80%, non-Black 74.5%; p=0.47; aRR 1.37, 95%CI[0.58-3.21]). 2hrGTT implementation was associated with a significant reduction in disparities in GTT completion by race (interaction p=0.02). There was no difference in PP attendance in either group by race (PRE aRR 2.67, 95%CI[0.87-8.08]; POST aRR 0.45 95%CI[0.14-1.41]; interaction p=0.08).

Conclusion:
There were significant racial disparities in 2hGTT adherence among GDM patients at baseline that were effectively eliminated after implementation of an inpatient PP 2hGTT. This highlights the importance of care access interventions in advancing health equity.