Maternal and neonatal outcomes in the Torres Strait Islands with a sixfold increase in type 2 diabetes in pregnancy over six years

Falhammar, Henrik, Davis, Bronwyn, Bond, Dianne, and Sinha, Ashim K. (2010) Maternal and neonatal outcomes in the Torres Strait Islands with a sixfold increase in type 2 diabetes in pregnancy over six years. Australian and New Zealand Journal of Obstetrics and Gynaecology, 50 (2). pp. 120-126.

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Abstract

Background: Torres Strait Islander population has a high prevalence of type 2 diabetes (T2DM).

Aims: To review pregnancy data of women and their newborns living in the Torres Strait area.

Methods: All medical charts of mothers and their neonates delivered in two one-year periods (1999 and 2005/2006) were reviewed. The initial screening test for diabetes in pregnancy (DIP) was a random blood glucose level followed by an oral glucose challenge test in 1999 and from 2000 an oral glucose tolerance test.

Results: Diabetes in pregnancy increased by 4.3–13.3% and T2DM by 0.8–4.6%. During the two periods, 258 and 196 mothers delivered respectively 84–92% by midwives/general practitioners at the local hospital and 7–16% by midwives/obstetricians at the regional hospital; in 2005/2006, 58% of women with DIP delivered at the regional hospital. Screening increased from 89.2 to 99.5%. DIP mothers were older and heavier with more hypertension and previous miscarriages. Parity decreased in the DIP mother during the two periods. Caesarean section was five times more common for DIP in 2005/2006 versus non-DIP, while in 1999, there was no difference. In 1999, the DIP infants were heavier, longer (P = 0.053) and had a larger head circumference not seen 2005/2006. There was more neonatal trauma, hypoglycaemia and IV dextrose in the DIP infants. Breastfeeding numbers increased in DIP. In 2005/2006, follow-up of gestational diabetes occurred in 47% (all normal).

Conclusion: A massive increase in DIP was seen. The neonatal outcomes improved slightly. There is need for improvement in follow-up of gestational diabetes.

Item ID: 46208
Item Type: Article (Refereed Research - C1)
Keywords: gestational diabetes, Indigenous, outcomes, screening, type 2 diabetes
ISSN: 1479-828X
Date Deposited: 08 Nov 2016 00:24
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110306 Endocrinology @ 34%
11 MEDICAL AND HEALTH SCIENCES > 1110 Nursing > 111006 Midwifery @ 33%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 33%
SEO Codes: 92 HEALTH > 9203 Indigenous Health > 920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes @ 33%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920104 Diabetes @ 34%
92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920507 Womens Health @ 33%
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