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Title: Pregnancy And Neonatal Diabetes Outcomes in Remote Australia: the PANDORA study-an observational birth cohort.
Authors: Maple-Brown, Louise
Lee, I-Lynn
Longmore, Danielle
Barzi, Federica
Connors, Christine
Boyle, Jacqueline A
Moore, Elizabeth
Whitbread, Cherie
Kirkwood, Marie
Graham, Sian
Hampton, Vanya
Simmonds, Alison
Van Dokkum, Paula
Kelaart, Joanna
Thomas, Sujatha
Chitturi, Shridhar
Eades, Sandra
Corpus, Sumaria
Lynch, Michael
Lu, Zhong X
O'Dea, Kerin
Zimmet, Paul
Oats, Jeremy
McIntyre, Harold D
Brown, Alex D H
Shaw, Jonathan E
Citation: International journal of epidemiology 2018-11-30
Abstract: In Australia's Northern Territory, 33% of babies are born to Indigenous mothers, who experience high rates of hyperglycemia in pregnancy. We aimed to determine the extent to which pregnancy outcomes for Indigenous Australian women are explained by relative frequencies of diabetes type [type 2 diabetes (T2DM) and gestational diabetes (GDM)]. This prospective birth cohort study examined participants recruited from a hyperglycemia in pregnancy register. Baseline data collected were antenatal and perinatal clinical information, cord blood and neonatal anthropometry. Of 1135 women (48% Indigenous), 900 had diabetes: 175 T2DM, 86 newly diagnosed diabetes in pregnancy (DIP) and 639 had GDM. A group of 235 women without hyperglycemia in pregnancy was also recruited. Diabetes type differed for Indigenous and non-Indigenous women (T2DM, 36 vs 5%; DIP, 15 vs 7%; GDM, 49 vs 88%, p < 0.001). Within each diabetes type, Indigenous women were younger and had higher smoking rates. Among women with GDM/DIP, Indigenous women demonstrated poorer birth outcomes than non-Indigenous women: large for gestational age, 19 vs 11%, p = 0·002; neonatal fat 11.3 vs 10.2%, p < 0.001. In the full cohort, on multivariate regression, T2DM and DIP were independently associated (and Indigenous ethnicity was not) with pregnancy outcomes. Higher rates of T2DM among Indigenous women predominantly contribute to absolute poorer pregnancy outcomes among Indigenous women with hyperglycemia. As with Indigenous and minority populations globally, prevention or delay of type 2 diabetes in younger women is vital to improve pregnancy outcomes and possibly to improve the long-term health of their offspring.
Click to open PubMed article: https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/30508095
Click to open Pubmed Article: https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/30508095
Journal title: International journal of epidemiology
Publication Date: 2018-11-30
Type: Journal Article
URI: https://hdl.handle.net/10137/7243
DOI: 10.1093/ije/dyy245
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