Dr. Lori Gore-Green | Women's Health Professional

Dr. Lori Gore-Green's Portfolio of Experience as a Women's Health Professional

New Predictors for Gestational Diabetes

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Dr. Lori Gore-GreenEarlier this month, Diabetes Care published a prospective cohort study that suggests that women who have high levels of abdominal fat (or abdominal adiposity) during their first trimester are at a greater  risk for developing diabetes later on in their pregnancy.

The study was limited to 485 women who were assessed for subcutaneous, visceral, and total adipose tissue depth with ultrasound between 11 and 14 weeks of gestation.

All of the subjects were between the ages of 18 and 42 years old, and the results accounted for confounding factors like; age, family history, ethnicity, BMI and more. Even with these factors addressed, researchers still found that women with higher levels of fat in their abdomens were likelier to develop diabetes between weeks twenty four to twenty eight of their pregnancy than their counterparts with less abdominal fat early on in pregnancy. To learn more about gestational diabetes, please see the video below:

Rural Areas Suffer Drop in OB/GYN Recruitment

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Dr. Lori Gore-GreenTraveling for healthcare services may be common for patients living in remote areas, but the difficulties accessing quality OB/GYN services has a direct link with an increased death rate among new mothers and their babies.

The face of the healthcare industry has been steadily changing over the last 30 years. As world-class tertiary hospitals pay doctors bigger salaries and buy out surrounding practices to stay afloat, the number of rural hospitals providing specialized services has dropped significantly. This is particularly the case with quality OB/GYN care — between 1985 and 2000, rural hospitals providing these services dropped by 23%, and that trend shows no sign of slowing down.

It has become notoriously difficult to recruit obstetricians and gynecologists to rural and remote areas. Smaller pay is only one of the barriers facing OB/GYN doctors considering the move — the lifestyle change is another. Getting accustomed to a small-town life isn’t necessarily easy for doctors who have grown up and studied in a suburban or urban environment.

Some hospitals are incentivizing the deal by offering new doctors things like student loan forgiveness, extra vacation time, and shortened work weeks. Mercy Medical Center, which serves the northern Iowa and southern Minnesota areas, is even offering a guaranteed income loan for the first year, which will then be forgiven after three years of service.

Only time will tell whether this trend really takes off. In the meantime, small rural hospitals are doing their best to partner up with clinicians in different specialities so they can continue to offer the right combination of skills to their patients. This works for about two-thirds of pregnancies who only need the kind of support offered in a rural clinic, but the other third require a more advanced care setting with emergency services.