The high prevalence of obesity in Indigenous Australian women has led to an earlier onset of Type 2 diabetes. The PANDORA study (Pregnancy and Neonatal Diabetes Outcomes from Remote Australia) is a prospective birth cohort study of women with hyperglycaemia in pregnancy (HIP) recruited in the Northern Territory. We describe the maternal characteristics and perinatal outcomes of Aboriginal and Europid women with gestational diabetes (GDM) and diabetes in pregnancy (DIP).
Aboriginal and Europid women with GDM (Aboriginal vs. Europid; n=149 vs. n=185) and diabetes first diagnosed in pregnancy (n=45 vs. n=6) were prospectively recruited. DIP was defined as an OGTT or HbA1c result first detected during pregnancy (WHO diabetes range). Women with diabetes diagnosed before the start of pregnancy were excluded from this analysis. Information collected included: antenatal and birth clinical information and neonatal anthropometry. Data were analysed using t-tests, chi-squared tests and multivariate linear regression.
Aboriginal women with DIP were more likely to be from remote areas than women with GDM (84.4 vs. 61.1%, p=0.004). There were no differences in age, first trimester BMI and gestational weight gain. DIP neonates had higher birth-weight z-scores (0.81 vs. 0.11, p=0.002) and thicker skinfold sums (15.4 vs. 13.0mm, p<0.001) than GDM neonates. There were no differences between DIP and GDM within the Europid group. On multivariate regression stratified by ethnicity, BMI was strongly associated with higher birth-weight z-score (β-coefficient 0.07, 95% CI 0.05-0.11, p<0.001) and thicker skinfold sums (β-coefficient 0.17, 95% CI 0.08-0.26, p<0.001), independent of glycaemic status and remoteness in Aboriginal women.
Maternal BMI was independently associated with birth-weight z-scores and skinfold sums in neonates born to Aboriginal pregnant women with GDM and DIP. The PANDORA study is a longitudinal study that will inform future cardio-metabolic risk following HIP for mothers and children, including among the high risk Aboriginal population.