Hare, Matthew

Maple-Brown, Louise

Shaw JE

Boyle JA

Lawton, Paul

Barr ELM

Guthridge S

Webster V

Hampton D

Singh, Gurmeet

Dyck RF

Barzi F

2023-01-18

AIMS/HYPOTHESIS: The aim of this work was to investigate the risk of developing chronic kidney disease (CKD) or end-stage kidney disease (ESKD) following a pregnancy complicated by gestational diabetes mellitus (GDM) or pre-existing diabetes among Aboriginal women in the Northern Territory (NT), Australia. METHODS: We undertook a longitudinal study of linked healthcare datasets. All Aboriginal women who gave birth between 2000 and 2016 were eligible for inclusion. Diabetes status in the index pregnancy was as recorded in the NT Perinatal Data Collection. Outcomes included any stage of CKD and ESKD as defined by ICD-10 coding in the NT Hospital Inpatient Activity dataset between 2000 and 2018. Risk was compared using Cox proportional hazards regression. RESULTS: Among 10,508 Aboriginal women, the mean age was 23.1 (SD 6.1) years; 731 (7.0%) had GDM and 239 (2.3%) had pre-existing diabetes in pregnancy. Median follow-up was 12.1 years. Compared with women with no diabetes during pregnancy, women with GDM had increased risk of CKD (9.2% vs 2.2%, adjusted HR 5.2 [95% CI 3.9, 7.1]) and ESKD (2.4% vs 0.4%, adjusted HR 10.8 [95% CI 5.6, 20.8]). Among women with pre-existing diabetes in pregnancy, 29.1% developed CKD (adjusted HR 10.9 [95% CI 7.7, 15.4]) and 9.9% developed ESKD (adjusted HR 28.0 [95% CI 13.4, 58.6]). CONCLUSIONS/INTERPRETATION: Aboriginal women in the NT with GDM or pre-existing diabetes during pregnancy are at high risk of developing CKD and ESKD. Pregnancy presents an important opportunity to identify kidney disease risk. Strategies to prevent kidney disease and address the social determinants of health are needed.

Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia. matthew.hare@menzies.edu.au.

Endocrinology Department, Royal Darwin Hospital, Darwin, NT, Australia. matthew.hare@menzies.edu.au.

Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.

Endocrinology Department, Royal Darwin Hospital, Darwin, NT, Australia.

Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.

Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia.

Department of Renal Medicine, Alfred Health, Melbourne, VIC, Australia.

Central Clinical School, Monash University, Melbourne, VIC, Australia.

Aboriginal and Torres Strait Islander Advisory Group, Diabetes across the Lifecourse: Northern Australia Partnership, Menzies School of Health Research, Darwin, NT, Australia.

Central Australian Aboriginal Congress, Alice Springs, NT, Australia.

Department of Medicine and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada.

UQ Poche Centre for Indigenous Health, University of Queensland, Brisbane, QLD, Australia.

Diabetologia . 2023 May;66(5):837-846. doi: 10.1007/s00125-023-05868-w. Epub 2023 Jan 18.

0000-0002-9364-3368

0000-0002-9067-2737

0000-0002-6187-2203

0000-0002-3616-1637

0000-0002-5754-4821

0000-0003-4284-1716

0000-0003-1495-764X

0000-0002-7352-1339

0000-0001-7427-0167

https://pubmed.ncbi.nlm.nih.gov/36651940/?otool=iaurydwlib

https://hdl.handle.net/10137/12378

Risk of kidney disease following a pregnancy complicated by diabetes: a longitudinal, population-based data-linkage study among Aboriginal women in the Northern Territory, Australia.

Journal Article

Publication