Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Maternal and birth outcomes of women with diabetes in pregnancy in the Northern Territory: PANDORA Study (#144)

I-Lynn Lee 1 , Alex Brown 2 , Christine Connors 3 , Cherie Whitbread 1 , Danielle Longmore 1 , Kerin O'Dea 4 , Jeremy Oats 5 , David McIntyre 6 , Jonathan Shaw 7 , Paul Zimmet 7 , Louise Maple-Brown 1
  1. Menzies School of Health Research, Casuarina, NT, Australia
  2. South Australian Health and Medical Research Institute, Adelaide, SA, Australia
  3. NT Department of Health, Darwin, NT, Australia
  4. University of South Australia, Adelaide, SA, Australia
  5. Melbourne School of Population and Global Health, Melbourne, VIC, Australia
  6. Mater Medical Research Institute, Brisbane, QLD, Australia
  7. Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia

Rates of Type 2 diabetes (T2DM) in pregnancy are increasing among Indigenous Australian women; this is of concern given the poorer outcomes compared to gestational diabetes (GDM). The PANDORA (Pregnancy and Neonatal Diabetes Outcomes from Remote Australia) Study aims to assess the rates and outcomes of mothers and babies with diabetes in pregnancy (DIP) in the Northern Territory (NT) where 38% of babies are born to Indigenous mothers.

Aims: To compare the maternal and birth outcomes of mothers with GDM to T2DM in pregnancy in the NT.

Methods: All NT women with DIP aged 16 years and over are eligible for PANDORA. The information collected included: antenatal clinical information, socio-economic questionnaire and standard birth information.

Results: From December 2011 to April 2014, 440 women with DIP were recruited. Among Indigenous women, T2DM in pregnancy n= 58, GDM n=115. Among non-Indigenous women, T2DM in pregnancy n=13, GDM n= 254. Comparing women with T2DM in pregnancy to GDM, age did not differ between 2 groups (30.6 vs 30.8 years); differences were evident for 1st trimester median body mass index (BMI) (30 vs 27kg/m2, p<0.001) and nulliparity (15.5% vs 38.5%, p<0.001). The incidence of the following was greater for T2DM in pregnancy than GDM: hypertension (16.9% vs 3.5%, p=0.001), pre-eclampsia (16% vs 2.5%, p<0.001), caesarean section (68.6% vs 42.5%, p=0.002). These differences remained significant after adjusting for age and ethnicity. Stillbirth was more common in women with T2DM in pregnancy (T2DM vs GDM, 2.8% vs 0%, p=0.02).

Conclusion: Indigenous women from NT are at high risk of T2DM in pregnancy.  Women with T2DM in pregnancy have poorer maternal outcomes compared to women with GDM. The PANDORA study is ongoing and will accurately document rates and outcomes of DIP in mothers and babies in the NT.