Trends and burden of diabetes in pregnancy among Aboriginal and non-Aboriginal mothers in Western Australia, 1998–2015

Background: Diabetes in pregnancy (DIP), which includes pre-gestational and gestational diabetes, is more prevalent among Aboriginal women. DIP and its adverse neonatal outcomes are associated with diabetes and cardiovascular disease in the offspring. This study investigated the impact of DIP on tre...

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Main Authors: Ahmed, M.A., Bailey, Helen, Pereira, Gavin, White, S.W., Wong, Kingsley, Shepherd, Carrington
Format: Journal Article
Language:English
Published: BMC 2022
Subjects:
Online Access:http://purl.org/au-research/grants/nhmrc/1127265
http://hdl.handle.net/20.500.11937/93234
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author Ahmed, M.A.
Bailey, Helen
Pereira, Gavin
White, S.W.
Wong, Kingsley
Shepherd, Carrington
author_facet Ahmed, M.A.
Bailey, Helen
Pereira, Gavin
White, S.W.
Wong, Kingsley
Shepherd, Carrington
author_sort Ahmed, M.A.
building Curtin Institutional Repository
collection Online Access
description Background: Diabetes in pregnancy (DIP), which includes pre-gestational and gestational diabetes, is more prevalent among Aboriginal women. DIP and its adverse neonatal outcomes are associated with diabetes and cardiovascular disease in the offspring. This study investigated the impact of DIP on trends of large for gestational age (LGA) in Aboriginal and non-Aboriginal populations, and added to the limited evidence on temporal trends of DIP burden in these populations. Methods: We conducted a retrospective cohort study that included all births in Western Australia between 1998 and 2015 using linked population health datasets. Time trends of age-standardised and crude rates of pre-gestational and gestational diabetes were estimated in Aboriginal and non-Aboriginal mothers. Mixed-effects multivariable logistic regression was used to estimate the association between DIP and population LGA trends over time. Results: Over the study period, there were 526,319 births in Western Australia, of which 6.4% were to Aboriginal mothers. The age-standardised annual rates of pre-gestational diabetes among Aboriginal mothers rose from 4.3% in 1998 to 5.4% in 2015 and remained below 1% in non-Aboriginal women. The comparable rates for gestational diabetes increased from 6.7 to 11.5% over the study period in Aboriginal women, and from 3.5 to 10.2% among non-Aboriginal mothers. LGA rates in Aboriginal babies remained high with inconsistent and no improvement in pregnancies complicated by gestational diabetes and pre-gestational diabetes, respectively. Regression analyses showed that DIP explained a large part of the increasing LGA rates over time in Aboriginal babies. Conclusions: There has been a substantial increase in the burden of pre-gestational diabetes (Aboriginal women) and gestational diabetes (Aboriginal and non-Aboriginal) in recent decades. DIP appears to substantially contribute to increasing trends in LGA among Aboriginal babies.
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spelling curtin-20.500.11937-932342024-04-19T08:43:58Z Trends and burden of diabetes in pregnancy among Aboriginal and non-Aboriginal mothers in Western Australia, 1998–2015 Ahmed, M.A. Bailey, Helen Pereira, Gavin White, S.W. Wong, Kingsley Shepherd, Carrington Science & Technology Life Sciences & Biomedicine Public, Environmental & Occupational Health Aboriginal Torres Strait Islanders Indigenous Diabetes in pregnancy Pre-gestational diabetes Gestational diabetes Large for gestational age NON-INDIGENOUS CHILDREN 1ST NATIONS BIRTH-WEIGHT PREVALENCE MELLITUS WOMEN RISK IMPACT ASSOCIATION EXPOSURE Aboriginal Diabetes in pregnancy Gestational diabetes Indigenous Large for gestational age Pre-gestational diabetes Torres Strait Islanders Diabetes, Gestational Female Humans Infant, Newborn Mothers Pregnancy Retrospective Studies Western Australia Humans Diabetes, Gestational Retrospective Studies Mothers Pregnancy Infant, Newborn Western Australia Female Background: Diabetes in pregnancy (DIP), which includes pre-gestational and gestational diabetes, is more prevalent among Aboriginal women. DIP and its adverse neonatal outcomes are associated with diabetes and cardiovascular disease in the offspring. This study investigated the impact of DIP on trends of large for gestational age (LGA) in Aboriginal and non-Aboriginal populations, and added to the limited evidence on temporal trends of DIP burden in these populations. Methods: We conducted a retrospective cohort study that included all births in Western Australia between 1998 and 2015 using linked population health datasets. Time trends of age-standardised and crude rates of pre-gestational and gestational diabetes were estimated in Aboriginal and non-Aboriginal mothers. Mixed-effects multivariable logistic regression was used to estimate the association between DIP and population LGA trends over time. Results: Over the study period, there were 526,319 births in Western Australia, of which 6.4% were to Aboriginal mothers. The age-standardised annual rates of pre-gestational diabetes among Aboriginal mothers rose from 4.3% in 1998 to 5.4% in 2015 and remained below 1% in non-Aboriginal women. The comparable rates for gestational diabetes increased from 6.7 to 11.5% over the study period in Aboriginal women, and from 3.5 to 10.2% among non-Aboriginal mothers. LGA rates in Aboriginal babies remained high with inconsistent and no improvement in pregnancies complicated by gestational diabetes and pre-gestational diabetes, respectively. Regression analyses showed that DIP explained a large part of the increasing LGA rates over time in Aboriginal babies. Conclusions: There has been a substantial increase in the burden of pre-gestational diabetes (Aboriginal women) and gestational diabetes (Aboriginal and non-Aboriginal) in recent decades. DIP appears to substantially contribute to increasing trends in LGA among Aboriginal babies. 2022 Journal Article http://hdl.handle.net/20.500.11937/93234 10.1186/s12889-022-12663-6 English http://purl.org/au-research/grants/nhmrc/1127265 http://purl.org/au-research/grants/nhmrc/1099655 http://purl.org/au-research/grants/nhmrc/1173991 http://creativecommons.org/licenses/by/4.0/ BMC fulltext
spellingShingle Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Aboriginal
Torres Strait Islanders
Indigenous
Diabetes in pregnancy
Pre-gestational diabetes
Gestational diabetes
Large for gestational age
NON-INDIGENOUS CHILDREN
1ST NATIONS
BIRTH-WEIGHT
PREVALENCE
MELLITUS
WOMEN
RISK
IMPACT
ASSOCIATION
EXPOSURE
Aboriginal
Diabetes in pregnancy
Gestational diabetes
Indigenous
Large for gestational age
Pre-gestational diabetes
Torres Strait Islanders
Diabetes, Gestational
Female
Humans
Infant, Newborn
Mothers
Pregnancy
Retrospective Studies
Western Australia
Humans
Diabetes, Gestational
Retrospective Studies
Mothers
Pregnancy
Infant, Newborn
Western Australia
Female
Ahmed, M.A.
Bailey, Helen
Pereira, Gavin
White, S.W.
Wong, Kingsley
Shepherd, Carrington
Trends and burden of diabetes in pregnancy among Aboriginal and non-Aboriginal mothers in Western Australia, 1998–2015
title Trends and burden of diabetes in pregnancy among Aboriginal and non-Aboriginal mothers in Western Australia, 1998–2015
title_full Trends and burden of diabetes in pregnancy among Aboriginal and non-Aboriginal mothers in Western Australia, 1998–2015
title_fullStr Trends and burden of diabetes in pregnancy among Aboriginal and non-Aboriginal mothers in Western Australia, 1998–2015
title_full_unstemmed Trends and burden of diabetes in pregnancy among Aboriginal and non-Aboriginal mothers in Western Australia, 1998–2015
title_short Trends and burden of diabetes in pregnancy among Aboriginal and non-Aboriginal mothers in Western Australia, 1998–2015
title_sort trends and burden of diabetes in pregnancy among aboriginal and non-aboriginal mothers in western australia, 1998–2015
topic Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Aboriginal
Torres Strait Islanders
Indigenous
Diabetes in pregnancy
Pre-gestational diabetes
Gestational diabetes
Large for gestational age
NON-INDIGENOUS CHILDREN
1ST NATIONS
BIRTH-WEIGHT
PREVALENCE
MELLITUS
WOMEN
RISK
IMPACT
ASSOCIATION
EXPOSURE
Aboriginal
Diabetes in pregnancy
Gestational diabetes
Indigenous
Large for gestational age
Pre-gestational diabetes
Torres Strait Islanders
Diabetes, Gestational
Female
Humans
Infant, Newborn
Mothers
Pregnancy
Retrospective Studies
Western Australia
Humans
Diabetes, Gestational
Retrospective Studies
Mothers
Pregnancy
Infant, Newborn
Western Australia
Female
url http://purl.org/au-research/grants/nhmrc/1127265
http://purl.org/au-research/grants/nhmrc/1127265
http://purl.org/au-research/grants/nhmrc/1127265
http://hdl.handle.net/20.500.11937/93234