The current state of Indigenous and Aboriginal women with diabetes in pregnancy: A systematic review

Porter, Cynthia; Skinner, Timothy; Ellis, Isabelle

doi:10.1016/j.diabres.2012.07.006

Cited by 36 publications

(48 citation statements)

References 51 publications

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“…This finding is supported by several studies that 86 found high rates of sexually transmitted infections (STIs) among Indigenous women of reproductive age living in rural communities [217,218] and pregnant Indigenous women living in urban areas [219]. Similarly, a population based study in Western Australia found infection to be an important cause of death for Indigenous infants [220].…”

Section: Perinatal Infectionsupporting

confidence: 68%

“…In Queensland, pre-existing and gestational diabetes affected around 0.6% and 6.7% of pregnancies [24]; while Australian national estimates are 0.6% and 4.7%, respectively [89]. There is evidence of increasing prevalence of pre-existing and gestational diabetes within Queensland [24,49]; with consistently higher rates of diabetes reported for Indigenous women [86]. Also of concern are reports of larger increases in the prevalence of gestational diabetes among non-Indigenous women [87].…”

Section: Introductionmentioning

confidence: 99%

“…Gestational diabetes (GDM) is carbohydrate intolerance resulting in hyperglycaemia of variable severity which is first recognised during pregnancy [9]. It was estimated that gestational diabetes affected 4.8-10.3% of pregnancies across various states and territories in Australia in 2012 [24]; and that GDM rates are higher among Indigenous women [86,87]. Risk factors for gestational diabetes include previous GDM, ethnicity (Asian including Indian, Aboriginal, Pacific Islander, Maori, Middle Eastern, non-white African), maternal age ≥ 40 years, family history of diabetes, obesity (BMI > 35kg/m 2 ), previous macrosomia (defined as birthweight > 4500g), polycystic ovarian syndrome and medications including corticosteroids and antipsychotics [9].…”

Section: Medical and Obstetric Factors Diabetesmentioning

confidence: 99%

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Preventing stillbirths: Better data to inform interventions in Australia

Ibiebele¹

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BackgroundIn Australia, one in every 139 women reaching 20 weeks gestation will have a stillborn baby. There is significant disparity in stillbirth rates within subgroups of the Australian population. Among Aboriginal and Torres Strait Islander (Indigenous) women, the stillbirth rate is one in every 93 women reaching 20 weeks gestation. Unfortunately, there has been no reduction in the national stillbirth rates over the past two decades and nearly a third are 'unexplained'. The ability to identify women at increased risk of stillbirth is an important and challenging priority. At present in Australia, there is a paucity of high quality data on causes and contributing factors to stillbirth. Furthermore, inconsistent approaches to investigation and classification affect the quality of data on causes of death and hamper the development of effective interventions to prevent stillbirth. AimsThe primary aim of this Thesis is to describe the epidemiology of stillbirth within the Australian context. This aim was addressed by: Examining trends in stillbirth by clinical classification of cause of death, Indigenous status and gestational age, to identify focal areas for preventive efforts  Assessing gestational age specific risk of stillbirth associated with four important contributors (diabetes, hypertension, antepartum haemorrhage and small-forgestational age) to higher stillbirth rates among Indigenous women in order to identify periods of increased risk  Developing and validating a statistical model to predict the risk of antepartum stillbirth at term (≥37 weeks) using maternal and pregnancy factors as a potential decision-making aid for clinicians and women  Assessing consistency in application of the Perinatal Society of Australia and New Zealand Perinatal Death Classification system between hospital committees and an independent expert panel, to identify areas for quality improvement  Determining maternal and pregnancy factors associated with parental consent to autopsy following stillbirth and explore parents' views and experiences of the autopsy consent process to inform clinical practice iii Methods and Results Data for 1995-2011 (n=881,211 singleton births) from the Queensland Perinatal DataCollection was analysed to address the first three aims. Stillbirth trends analysis found consistently higher rates of stillbirth among Indigenous women, however, the gap in stillbirth rates had narrowed. Gestational age specific stillbirth risk analysis found disparity in the magnitude of stillbirth risk for pre-existing diabetes and small-for-gestational age between Indigenous and non-Indigenous women. Despite strong association between maternal clinical factors and antepartum stillbirth risk, the prediction model had a poor ability to predict stillbirth risk at term.Consistency in application of the perinatal death classification system was assessed by calculating agreement. A substantial level of agreement was found between hospital committee and expert panel review of a cohort of 217 stillbirth cases, howeve...

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Section: Perinatal Infectionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Section: Medical and Obstetric Factors Diabetesmentioning

confidence: 99%

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Preventing stillbirths: Better data to inform interventions in Australia

Ibiebele¹

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“…In Australia, the prevalence of both DM or GDM is higher among the aboriginal population. 1 The authors also reviewed literature from the United States, Canada and Asia Pacific countries, and determined that the prevalence of diabetes during pregnancy is higher among aboriginal women. 1 The current study is the first to perform a hospital-based comparison of ethnic differences in GDM prevalence in Taiwan.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported that these groups have a higher prevalence rate of GDM than do non-indigenous or nonaboriginal populations. 1 A previous study conducted in Taiwan indicated that Taiwanese aboriginal people exhibit a lower prevalence of type 2 diabetes mellitus than do other ethnic groups. 2,3 The majority of these aboriginal people live in remote mountainous areas, tend to engage in manual labour and have lower socioeconomic statuses.…”

Section: Introductionmentioning

confidence: 99%