Maternal and neonatal outcomes following diabetes in pregnancy in Far North Queensland, Australia.
BACKGROUND
Diabetes in pregnancy (DIP) is increasing and is associated with a number of adverse consequences for both the mother and the child.


OBJECTIVE
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.


CONCLUSIONS
The local cohort had poorer outcomes probably reflecting a more disadvantaged. Few differences were found between local Indigenous groups.
Davis
Bronwyn
B
Cairns Diabetes Centre, Cairns, Queensland, Australia.
Bond
Dianne
D
Howat
Paul
P
Sinha
Ashim K
AK
Falhammar
Henrik
H
D000328:Adult; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D005865:Gestational Age; D005951:Glucose Tolerance Test; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D008485:Medical Audit; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D018566:Pregnancy, High-Risk / Q000208:ethnology*; D011793:Queensland / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult