Diabetes during pregnancy and birthweight trends among Aboriginal and non-Aboriginal people in the Northern Territory of Australia over 30 years

Diabetes during pregnancy and birthweight trends among Aboriginal and non-Aboriginal people in the Northern Territory of Australia over 30 years Journal Article

The Lancet Regional Health - Western Pacific

• Author(s): Hare, Matthew J. L., Barzi, Federica, Boyle, Jacqueline A., Guthridge, Steven, Dyck, Roland F., Barr, Elizabeth L. M., Singh, Gurmeet, Falhammar, Henrik, Webster, Vanya, Shaw, Jonathan E., Maple-Brown, Louise J.
• Published: 2020
• ISBN: 2666-6065

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Abstract: 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.

• Urls: http://www.sciencedirect.com/science/article/pii/S2666606520300055