The epidemiology of diabetes in pregnant Native Canadians. A risk profile.
OBJECTIVE
The purpose of this study was to determine the prevalence of diabetes in pregnancy (gestational diabetes mellitus [GDM] and NIDDM) and to identify risk factors in the development of GDM in a native population in northwestern Ontario, Canada.


METHODS
A retrospective analysis of 1,305 singleton deliveries among Ojibwa-Cree women from northwestern Ontario, Canada, was conducted from 1990 to 1993 inclusive. GDM was diagnosed using a 3-h oral glucose tolerance test (OGTT) and defined according to standard guidelines.


RESULTS
The overall prevalence of diabetes in pregnancy (NIDDM and GDM) was 11.6% (152 of 1,305) with a GDM prevalence of 8.4% (110 of 1,305). Among 741 women with complete data, prevalence rates increased with age, peaking at 46.9% in the age-group > or = 35 years. Significant risk factors for GDM included older maternal age, multiparity, prepregnancy obesity, a family history of diabetes, and a history of GDM in previous pregnancies.


CONCLUSIONS
Diabetes in pregnancy among Ojibwa-Cree reported here represent the highest rates reported to date in a Canadian population. The high rates of maternal obesity and relative young age of this population further highlight the urgent need for diabetes screening and prevention in this population.
Harris
S B
SB
Department of Family Medicine, University of Western Ontario, London, Canada. sharris1@julian.uwo.ca
Caulfield
L E
LE
Sugamori
M E
ME
Whalen
E A
EA
Henning
B
B
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000503:physiopathology; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data*; D016015:Logistic Models; D008423:Maternal Age; D009765:Obesity; D009864:Ontario / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors