Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study

Abstract

BackgroundDiabetes in pregnancy carries an increased risk of adverse pregnancy outcomes for both the mother and foetus, but it also provides an excellent early opportunity for intervention in the life course for both mother and baby. In the context of the escalating epidemic of chronic diseases among Indigenous Australians, it is vital that this risk is reduced as early as possible in the life course of the individual. The aims of the PANDORA Study are to: (i) accurately assess rates of diabetes in pregnancy in the Northern Territory (NT) of Australia, where 38% of babies are born to Indigenous mothers; (ii) assess demographic, clinical, biochemical, anthropometric, socioeconomic and early life development factors that may contribute to key maternal and neonatal birth outcomes associated with diabetes in pregnancy; and (iii) monitor relevant post-partum clinical outcomes for both the mothers and their babies.Methods/DesignEligible participants are all NT women with diabetes in pregnancy aged 16 years and over. Information collected includes: standard antenatal clinical information, diagnosis and management of diabetes in pregnancy, socio-economic status, standard clinical birth information (delivery, gestational age, birth weight, adverse antenatal and birth outcomes). Cord blood is collected at the time of delivery and detailed neonatal anthropometric measurements performed within 72 hours of birth. Information will also be collected regarding maternal post-partum glucose tolerance and cardio-metabolic risk factor status, breastfeeding and growth of the baby up to 2 years post-partum in the first instance.DiscussionThis study will accurately document rates and outcomes of diabetes in pregnancy in the NT of Australia, including the high-risk Indigenous Australian population. The results of this study should contribute to policy and clinical guidelines with the goal of reducing the future risk of obesity and diabetes in both mothers and their offspring.

Associations with low rates of postpartum glucose screening after gestational diabetes among Indigenous and non‐Indigenous Australian women

“…However it is unclear how universal the current uptake is, with some suggestions it may be lower among Indigenous women 72 . Other initiatives within Australia include the development of clinical registers for GDM in the Northern Territory, 73 and text‐messaging reminders for women in South Australia 74 . While these current strategies address individual level factors such as lack of awareness and forgetting about the need for the test, it is likely there is a need to do more to address other barriers.…”

Preconception care for women with type 2 diabetes mellitus: A mixed-methods study of provider knowledge and practice

“…The National Health and Medical Research Council (NHMRC) funded NT DIP Partnership was established to address diabetes in pregnancy in the particularly high risk populations of this region [22]. The Partnership has three arms: (i) the establishment of the NT DIP Clinical register; (ii) improving models of care for mothers experiencing hyperglycaemia in pregnancy; and (iii) a longitudinal observational research study [22].…”

“…The Partnership has three arms: (i) the establishment of the NT DIP Clinical register; (ii) improving models of care for mothers experiencing hyperglycaemia in pregnancy; and (iii) a longitudinal observational research study [22]. This research is a component of the models of care arm of this Partnership.…”

Improving health service delivery for women with diabetes in pregnancy in remote Australia: survey of care in the Northern Territory Diabetes in Pregnancy Partnership

“… Review and enhancement of the current models of care in the NT for DIP Development of a NT DIP Clinical Register Detailed research project (Pregnancy and Neonatal Diabetes Outcomes in Remote Australia; PANDORA) …”