Maternal and neonatal outcomes following diabetes in pregnancy in Far North Queensland, Australia

Aust N Z J Obstet Gynaecol. 2009 Aug;49(4):393-9. doi: 10.1111/j.1479-828X.2009.01021.x.

Abstract

Background: Diabetes in pregnancy (DIP) is increasing and is associated with a number of adverse consequences for both the mother and the child.

Aims: To compare local maternal and neonatal outcomes with state and national data.

Methods: Chart audit of all DIP delivered during 2004 at a regional teaching hospital and compare outcomes with national benchmark, Queensland and national Indigenous data.

Results: The local DIP frequency was 6.7%. The local compared to benchmark and state data demonstrated a higher frequency of Indigenous mothers (43.6% vs 6.8% vs 5.5%), caesarean sections (50.7% vs 26% vs 32.0%), hypoglycaemia (40.7% vs 19.5% vs 2.7%) and respiratory distress (16.6% vs 4.5% vs 2.3%) in infants, fewer normal birthweights (64.8% vs 82.6% vs 80.4%) and full-term deliveries. More local mothers compared to benchmark had type 2 diabetes mellitus (T2DM) (15.4% vs 8.7%) but fewer used insulin (31.0% vs 46.6%); compared to state data, fewer women had gestational diabetes (79.5% vs 91.2%), however, insulin use was higher (22.8%). Furthermore, Aborigines had fewer pregnancies compared to Torres Strait Islanders (3.0 vs 5.0) and less insulin use (21.9% vs 59.3%) (P = 0.008-0.024). In contrast, non-Indigenous versus Indigenous women showed fewer pregnancies, less T2DM (7.8% vs 23.7%), better glycaemic control, longer babies, more full-term deliveries and less severe neonatal hypoglycaemia. Comparing local and national Indigenous data, local showed poorer outcomes, however, only 11.8% had diabetes or hypertension nationally.

Conclusion: The local cohort had poorer outcomes probably reflecting a more disadvantaged. Few differences were found between local Indigenous groups.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Diabetes, Gestational / diagnosis
  • Diabetes, Gestational / epidemiology*
  • Diabetes, Gestational / ethnology
  • Female
  • Gestational Age
  • Glucose Tolerance Test
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases / epidemiology
  • Infant, Premature
  • Infant, Small for Gestational Age
  • Medical Audit
  • Middle Aged
  • Native Hawaiian or Other Pacific Islander
  • Pregnancy
  • Pregnancy Outcome / ethnology*
  • Pregnancy, High-Risk / ethnology*
  • Queensland / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Young Adult