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Type: Journal article
Title: Pregnancy and neonatal diabetes outcomes in remote Australia: the PANDORA study - an observational birth cohort
Author: Maple-Brown, L.
Lee, I.
Longmore, D.
Barzi, F.
Connors, C.
Boyle, J.
Moore, E.
Whitbread, C.
Kirkwood, M.
Graham, S.
Hampton, V.
Simmonds, A.
Van Dokkum, P.
Kelaart, J.
Thomas, S.
Chitturi, S.
Eades, S.
Corpus, S.
Lynch, M.
Lu, Z.
et al.
Citation: International Journal of Epidemiology, 2019; 48(1):307-318
Publisher: Oxford University Press
Issue Date: 2019
ISSN: 0300-5771
Statement of
Louise Maple-Brown, I-Lynn Lee, Danielle Longmore, Federica Barzi, Christine Connors ... Alex DH Brown ... et al.
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.
Keywords: Gestational diabetes; type 2 diabetes in pregnancy; hyperglycemia in pregnancy; diabetes in pregnancy; Aboriginal; Indigenous Australian; birth cohort
Rights: © The Author(s) 2018; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association
RMID: 0030111506
DOI: 10.1093/ije/dyy245
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