Antenatal health and perinatal outcomes of Pacific Islander women in Australia with and without gestational diabetes: A ten-year retrospective cohort study

IF 1.4 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology Pub Date : 2024-04-25 DOI:10.1111/ajo.13826

Annabel S. Jones, Jessica Deitch, Christopher Yates, Peter Shane Hamblin, Glyn Teale, Dev Kevat, I-Lynn Lee

{"title":"Antenatal health and perinatal outcomes of Pacific Islander women in Australia with and without gestational diabetes: A ten-year retrospective cohort study","authors":"Annabel S. Jones, Jessica Deitch, Christopher Yates, Peter Shane Hamblin, Glyn Teale, Dev Kevat, I-Lynn Lee","doi":"10.1111/ajo.13826","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Background</h3>\n \n <p>Pacific Islander (PI) women in Australia have an increased risk of gestational diabetes (GDM); however, their perinatal outcomes are poorly understood.</p>\n </section>\n \n <section>\n \n <h3> Aim</h3>\n \n <p>The aim was to determine the maternal characteristics and perinatal outcomes of PI women with and without GDM compared to Australian/European (AE)–born women.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A retrospective analysis of perinatal outcomes of singleton deliveries >20 weeks’ gestation between 1 January 2011 and 31 December 2020 was conducted at a tertiary provider (Melbourne, Australia). Antenatal details and birth outcomes were extracted from the Birth Outcome Systems database. <i>t</i>-Tests and χ<sup>2</sup>, univariate and multivariable logistic regression analyses assessed the relationship between ethnicity and outcomes.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of 52,795 consecutive births, 24,860 AE women (13.3% with GDM) and 1207 PI-born women (20.1% with GDM) were compared. PI women had significantly greater pre-pregnancy body mass index (BMI) and significantly lower rates of smoking and nulliparity. PI women with GDM had higher rates of pre-eclampsia (<i>P</i> < 0.001), large-for-gestational age (LGA) neonates (<i>P</i> = 0.037) and neonatal hypoglycaemia (<i>P</i> = 0.017) but lower rates of small-for-gestational age neonates (<i>P</i> = 0.034). Neonatal intensive care unit (NICU)/special care nursery requirements did not increase. After having adjusted for covariates, PI women's risk of LGA neonates (adjusted odds ratio (aOR): 1.06, 95% confidence interval (CI): 0.86–1.31) was attenuated; however, risk of pre-eclampsia (aOR: 1.49, 95% CI: 1.01–2.21) and neonatal hypoglycaemia (aOR: 1.40, 95% CI: 1.01–1.96) still increased. They were less likely to require a primary caesarean section (aOR: 0.86, 95% CI: 0.73–0.99).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>PI women have higher BMI and GDM rates, contributing to an increased likelihood of adverse perinatal outcomes. BMI is a modifiable risk factor that could be addressed prenatally.</p>\n </section>\n </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"64 5","pages":"494-500"},"PeriodicalIF":1.4000,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13826","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australian & New Zealand Journal of Obstetrics & Gynaecology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ajo.13826","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Pacific Islander (PI) women in Australia have an increased risk of gestational diabetes (GDM); however, their perinatal outcomes are poorly understood.

Aim

The aim was to determine the maternal characteristics and perinatal outcomes of PI women with and without GDM compared to Australian/European (AE)–born women.

Methods

A retrospective analysis of perinatal outcomes of singleton deliveries >20 weeks’ gestation between 1 January 2011 and 31 December 2020 was conducted at a tertiary provider (Melbourne, Australia). Antenatal details and birth outcomes were extracted from the Birth Outcome Systems database. t-Tests and χ², univariate and multivariable logistic regression analyses assessed the relationship between ethnicity and outcomes.

Results

Of 52,795 consecutive births, 24,860 AE women (13.3% with GDM) and 1207 PI-born women (20.1% with GDM) were compared. PI women had significantly greater pre-pregnancy body mass index (BMI) and significantly lower rates of smoking and nulliparity. PI women with GDM had higher rates of pre-eclampsia (P < 0.001), large-for-gestational age (LGA) neonates (P = 0.037) and neonatal hypoglycaemia (P = 0.017) but lower rates of small-for-gestational age neonates (P = 0.034). Neonatal intensive care unit (NICU)/special care nursery requirements did not increase. After having adjusted for covariates, PI women's risk of LGA neonates (adjusted odds ratio (aOR): 1.06, 95% confidence interval (CI): 0.86–1.31) was attenuated; however, risk of pre-eclampsia (aOR: 1.49, 95% CI: 1.01–2.21) and neonatal hypoglycaemia (aOR: 1.40, 95% CI: 1.01–1.96) still increased. They were less likely to require a primary caesarean section (aOR: 0.86, 95% CI: 0.73–0.99).

Conclusion

PI women have higher BMI and GDM rates, contributing to an increased likelihood of adverse perinatal outcomes. BMI is a modifiable risk factor that could be addressed prenatally.

Abstract Image

查看原文本刊更多论文

患有和未患有妊娠糖尿病的澳大利亚太平洋岛民妇女的产前健康和围产期结果：一项为期十年的回顾性队列研究

背景澳大利亚的太平洋岛民（PI）妇女罹患妊娠期糖尿病（GDM）的风险较高；然而，对她们的围产期结局却知之甚少。方法在一家三级医疗机构（澳大利亚墨尔本）对 2011 年 1 月 1 日至 2020 年 12 月 31 日期间妊娠 20 周的单胎分娩围产期结局进行了回顾性分析。结果在52795名连续分娩的产妇中，24860名AE产妇（13.3%患有GDM）和1207名PI产妇（20.1%患有GDM）进行了比较。PI产妇的孕前体重指数（BMI）明显高于AE产妇，吸烟率和无生育要求的比例明显低于AE产妇。患有 GDM 的 PI 妇女先兆子痫（P < 0.001）、大胎龄（LGA）新生儿（P = 0.037）和新生儿低血糖（P = 0.017）的发病率较高，但小胎龄新生儿（P = 0.034）的发病率较低。新生儿重症监护室（NICU）/特殊护理室的需求没有增加。在对协变量进行调整后，PI 妇女的 LGA 新生儿风险（调整后比值比 (aOR)：1.06，95% 置信区间 (CI)：0.86-1.31）有所降低；但是，先兆子痫风险（aOR：1.49，95% CI：1.01-2.21）和新生儿低血糖风险（aOR：1.40，95% CI：1.01-1.96）仍然增加。结论婴儿体重指数（BMI）和糖化血红蛋白（GDM）较高的妇女，增加了围产期不良结局的可能性。体重指数是一个可改变的风险因素，可以在产前加以控制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Australian & New Zealand Journal of Obstetrics & Gynaecology 医学-妇产科学

CiteScore

3.40

自引率

11.80%

发文量

165

审稿时长

4-8 weeks

期刊介绍： The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.