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Abstract:
In this issue of The Lancet Regional Health-Western Pacific, Hare and colleagues have reported on over three decades of data on hyperglycaemia (defined as pre-existing and gestational diabetes) during pregnancy and birthweight trends in a cohort of Aboriginal and non-Aboriginal women from the Northern Territory, Australia. [1] The authors report on the increase in rates over time in gestational diabetes (3.4% in 1987 to 13% in 2016) and pre-existing diabetes (0.6% in 1987 to 5.7% in 2016) in pregnant Aboriginal women. A similar increasing trend for gestational diabetes was also reported for non-Aboriginal women (1.9% in 1987 to 11% in 2016), with no change in pre-existing diabetes (≤0.7% throughout). Along with the increase in hyperglycaemia over time there was also a decrease in small-for-gestational-age for both Aboriginal and non-Aboriginal mothers. Despite this important decrease, there was a significant concurrent increase over time for large-for-gestational-age and high birthweight (>4000g) infants for both Aboriginal and non-Aboriginal mothers with the average increase for Aboriginal mothers greater than non-Aboriginal mothers. Importantly when investigating the contribution of hyperglycaemia during pregnancy on large for gestational age infants, the authors found that there was a strong association over time.
