Pregnancy And Neonatal Diabetes Outcomes in Remote Australia: the PANDORA study—an observational birth cohort
Year: 2018
Type: article
Study design: Observational Study
Abstract: BACKGROUND: 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)]. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
DOI: 10.1093/ije/dyy245
Authors: Louise Maple-Brown, I-Lynn Lee, Danielle Longmore, Federica Barzi, Christine Connors, Jacqueline A Boyle, Elizabeth Moore, Cherie Whitbread, Marie Kirkwood, Sian Graham, Vanya Hampton, Alison Simmonds, Paula Van Dokkum, Joanna Kelaart, Sujatha Thomas, Shridhar Chitturi, Sandra Eades, Sumaria Corpus, Michael Lynch, Zhong X Lu, Kerin O'Dea, Paul Zimmet, Jeremy Oats, Harold D McIntyre, Alex D H Brown, Jonathan E Shaw, Stacey Svenson, Lynice Wood, Liz Davis, G Dent, M Stone, M Harris, C Inglis, K Dempsey
Institutions: Menzies School of Health Research, Royal Darwin Hospital, Government of the Northern Territory, Northern Territory Health Services, Monash University, Baker Heart and Diabetes Institute, University of South Australia, The University of Melbourne, The University of Queensland, South Australian Health and Medical Research Institute
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Awards: Birth outcomes and body composition in babies born to mothers with diabetes in pregnancy, Diabetes and obesity: from benchtop to public health, NTDIP: Northern Territory Diabetes in Pregnancy Project, Improving outcomes of diabetes and related conditions for Indigenous Australians: causes, intervention, system change, Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) Cohort, Improving chronic disease outcomes for Indigenous Australians: Causes,Interventions, System Change, Improving management of diabetes and chronic kidney disease in Indigenous Australians
OpenAlex ID: W2902827977