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

Abstract

BackgroundPacific Islander (PI) women in Australia have an increased risk of gestational diabetes (GDM); however, their perinatal outcomes are poorly understood.AimThe aim was to determine the maternal characteristics and perinatal outcomes of PI women with and without GDM compared to Australian/European (AE)–born women.MethodsA 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.ResultsOf 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).ConclusionPI 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.