The authors have nothing to disclose.Author details: Bronwyn Davis, RN, Credentialled Diabetes Educator/Midwife; Dianne Bond, RN, Credentialled Diabetes Educator/Midwife; Paul Howat, MB BS, FRACP, Obstetrics and Gynaecologist, Director; Ashim K Sinha, MB BS, MD, FRACP, FACE, Endocrinologist, Director; Henrik Falhammar, MD, Endocrinologist.
Maternal and neonatal outcomes following diabetes in pregnancy in Far North Queensland, Australia
Article first published online: 2 JUN 2009
© 2009 The Authors. Journal compilation © 2009 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists
Australian and New Zealand Journal of Obstetrics and Gynaecology
Volume 49, Issue 4, pages 393–399, August 2009
How to Cite
DAVIS, B., BOND, D., HOWAT, P., SINHA, A. K. and FALHAMMAR, H. (2009), Maternal and neonatal outcomes following diabetes in pregnancy in Far North Queensland, Australia. Australian and New Zealand Journal of Obstetrics and Gynaecology, 49: 393–399. doi: 10.1111/j.1479-828X.2009.01021.x
- Issue published online: 29 JUL 2009
- Article first published online: 2 JUN 2009
- Received 1 December 2008; accepted 04 April 2009.
- caesarean section;
- gestational diabetes;
- type 2 diabetes mellitus
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.