Diabetes during pregnancy and birthweight trends among Aboriginal and non-Aboriginal people in the Northern Territory of Australia over 30 years
Background: Early-life risk factors, including maternal hyperglycaemia and birthweight, are thought to contribute to the high burden of cardiometabolic disease experienced by Indigenous populations. We examined rates of pre-existing diabetes in pregnancy, gestational diabetes mellitus (GDM) and extr...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-08-01
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| Series: | The Lancet Regional Health. Western Pacific |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666606520300055 |
| _version_ | 1818859788107251712 |
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| author | Matthew J.L. Hare Federica Barzi Jacqueline A. Boyle Steven Guthridge Roland F. Dyck Elizabeth L.M. Barr Gurmeet Singh Henrik Falhammar Vanya Webster Jonathan E. Shaw Louise J. Maple-Brown |
| author_facet | Matthew J.L. Hare Federica Barzi Jacqueline A. Boyle Steven Guthridge Roland F. Dyck Elizabeth L.M. Barr Gurmeet Singh Henrik Falhammar Vanya Webster Jonathan E. Shaw Louise J. Maple-Brown |
| author_sort | Matthew J.L. Hare |
| collection | DOAJ |
| description | Background: Early-life risk factors, including maternal hyperglycaemia and birthweight, are thought to contribute to the high burden of cardiometabolic disease experienced by Indigenous populations. We examined rates of pre-existing diabetes in pregnancy, gestational diabetes mellitus (GDM) and extremes of birthweight over three decades in the Northern Territory (NT) of Australia. Methods: We performed a retrospective cohort analysis of the NT Perinatal Data Collection from 1987 to 2016, including all births >20 weeks gestation, stratified by maternal Aboriginal identification. Key outcomes were annual rates of pre-existing diabetes, GDM, small-for-gestational-age, large-for-gestational-age, low birthweight (<2500 g), and high birthweight (>4000 g). Logistic regression was used to assess trends and interactions. Findings: 109 349 babies were born to 64 877 mothers, 36% of whom identified as Aboriginal ethnicity. Among Aboriginal women, rates of GDM and pre-existing diabetes, respectively, were 3 · 4% and 0 · 6% in 1987 and rose to 13% and 5 · 7% in 2016 (both trends p<0 · 001). Among non-Aboriginal women, rates of GDM increased from 1 · 9% in 1987 to 11% in 2016 (p<0 · 001), while pre-existing diabetes was uncommon (≤0 · 7% throughout). Rates of small-for-gestational-age decreased, while rates of large-for-gestational-age and high birthweight increased in both groups (all trends p<0 · 001). Multivariable modelling suggests that hyperglycaemia was largely responsible for the growing rate of large-for-gestational-age births among Aboriginal women. Interpretation: The burden of hyperglycaemia in pregnancy has grown substantially in the NT over three decades and is impacting birthweight trends. The prevalence of pre-gestational diabetes in Aboriginal women is among the highest in the world. Funding: Diabetes Australia Research Program. |
| first_indexed | 2024-12-19T09:17:45Z |
| format | Article |
| id | doaj.art-6f17cc2df8ca43e28a2db70582a62b84 |
| institution | Directory Open Access Journal |
| issn | 2666-6065 |
| language | English |
| last_indexed | 2024-12-19T09:17:45Z |
| publishDate | 2020-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Western Pacific |
| spelling | doaj.art-6f17cc2df8ca43e28a2db70582a62b842022-12-21T20:28:04ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652020-08-011100005Diabetes during pregnancy and birthweight trends among Aboriginal and non-Aboriginal people in the Northern Territory of Australia over 30 yearsMatthew J.L. Hare0Federica Barzi1Jacqueline A. Boyle2Steven Guthridge3Roland F. Dyck4Elizabeth L.M. Barr5Gurmeet Singh6Henrik Falhammar7Vanya Webster8Jonathan E. Shaw9Louise J. Maple-Brown10Wellbeing and Chronic Preventable Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Department of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, Australia; Corresponding author at: Wellbeing and Chronic Preventable Diseases Division, Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT 0811, Australia.Wellbeing and Chronic Preventable Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, AustraliaMonash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, AustraliaCentre for Child Development and Education, Menzies School of Health Research, Darwin, Northern Territory, AustraliaDepartment of Medicine, Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, CanadaWellbeing and Chronic Preventable Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, Melbourne, Victoria, AustraliaChild Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia; Department of Paediatrics, Royal Darwin Hospital, Darwin, Northern Territory, AustraliaWellbeing and Chronic Preventable Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Department of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, Australia; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, SwedenIndigenous Reference Group, Diabetes across the Lifecourse: Northern Australia Partnership, Menzies School of Health Research, Darwin, Northern Territory, AustraliaClinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, AustraliaWellbeing and Chronic Preventable Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Department of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, AustraliaBackground: Early-life risk factors, including maternal hyperglycaemia and birthweight, are thought to contribute to the high burden of cardiometabolic disease experienced by Indigenous populations. We examined rates of pre-existing diabetes in pregnancy, gestational diabetes mellitus (GDM) and extremes of birthweight over three decades in the Northern Territory (NT) of Australia. Methods: We performed a retrospective cohort analysis of the NT Perinatal Data Collection from 1987 to 2016, including all births >20 weeks gestation, stratified by maternal Aboriginal identification. Key outcomes were annual rates of pre-existing diabetes, GDM, small-for-gestational-age, large-for-gestational-age, low birthweight (<2500 g), and high birthweight (>4000 g). Logistic regression was used to assess trends and interactions. Findings: 109 349 babies were born to 64 877 mothers, 36% of whom identified as Aboriginal ethnicity. Among Aboriginal women, rates of GDM and pre-existing diabetes, respectively, were 3 · 4% and 0 · 6% in 1987 and rose to 13% and 5 · 7% in 2016 (both trends p<0 · 001). Among non-Aboriginal women, rates of GDM increased from 1 · 9% in 1987 to 11% in 2016 (p<0 · 001), while pre-existing diabetes was uncommon (≤0 · 7% throughout). Rates of small-for-gestational-age decreased, while rates of large-for-gestational-age and high birthweight increased in both groups (all trends p<0 · 001). Multivariable modelling suggests that hyperglycaemia was largely responsible for the growing rate of large-for-gestational-age births among Aboriginal women. Interpretation: The burden of hyperglycaemia in pregnancy has grown substantially in the NT over three decades and is impacting birthweight trends. The prevalence of pre-gestational diabetes in Aboriginal women is among the highest in the world. Funding: Diabetes Australia Research Program.http://www.sciencedirect.com/science/article/pii/S2666606520300055 |
| spellingShingle | Matthew J.L. Hare Federica Barzi Jacqueline A. Boyle Steven Guthridge Roland F. Dyck Elizabeth L.M. Barr Gurmeet Singh Henrik Falhammar Vanya Webster Jonathan E. Shaw Louise J. Maple-Brown Diabetes during pregnancy and birthweight trends among Aboriginal and non-Aboriginal people in the Northern Territory of Australia over 30 years The Lancet Regional Health. Western Pacific |
| title | Diabetes during pregnancy and birthweight trends among Aboriginal and non-Aboriginal people in the Northern Territory of Australia over 30 years |
| title_full | Diabetes during pregnancy and birthweight trends among Aboriginal and non-Aboriginal people in the Northern Territory of Australia over 30 years |
| title_fullStr | Diabetes during pregnancy and birthweight trends among Aboriginal and non-Aboriginal people in the Northern Territory of Australia over 30 years |
| title_full_unstemmed | Diabetes during pregnancy and birthweight trends among Aboriginal and non-Aboriginal people in the Northern Territory of Australia over 30 years |
| title_short | Diabetes during pregnancy and birthweight trends among Aboriginal and non-Aboriginal people in the Northern Territory of Australia over 30 years |
| title_sort | diabetes during pregnancy and birthweight trends among aboriginal and non aboriginal people in the northern territory of australia over 30 years |
| url | http://www.sciencedirect.com/science/article/pii/S2666606520300055 |
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