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

Authors

  • Bronwyn DAVIS,

    1. Cairns Diabetes Centre, Cairns, Queensland, Australia
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  • Dianne BOND,

    1. Cairns Diabetes Centre, Cairns, Queensland, Australia
    2. Obstetrics and Gynaecology Clinical Care Unit, Diabetes Service, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia
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  • Paul HOWAT,

    1. Department of Obstetrics and Gynaecology, Cairns Base Hospital, Cairns, Queensland, Australia
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  • Ashim K SINHA,

    1. Cairns Diabetes Centre, Cairns, Queensland, Australia
    2. Department of Endocrinology, Cairns Base Hospital, Cairns, Queensland, Australia
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  • Henrik FALHAMMAR

    1. Cairns Diabetes Centre, Cairns, Queensland, Australia
    2. Department of Endocrinology, Cairns Base Hospital, Cairns, Queensland, Australia
    3. Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
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  • 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.

: Dr Henrik Falhammar, Diabetes Centre/Cairns Base Hospital, PO Box 902, Cairns, Qld 4870, Australia. Email: henrik.falhammar@ki.se

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.

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