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New report highlights prevalence of diabetes in pregnancy


Evelyn Lewin


13/02/2019 11:07:28 AM

Mothers and babies suffer poorer health outcomes when a woman has pre-existing or gestational diabetes.

Diabetes affects nearly one in 10 pregnancies.
Diabetes affects nearly one in 10 pregnancies.

Diabetes affects nearly one in 10 pregnancies, according to data released today by the Australian Institute of Health and Welfare (AIHW).  
 
Diabetes in pregnancy 2014–2015 found that more than 45,000 mothers who gave birth in Australia (excluding Victoria) had diabetes in that time period.
 
That represents 9.9% of births recorded in the National Perinatal Data Collective (NPDC).
 
Of these women, 8.9% (40,500 women) had gestational diabetes. The remaining 1% (4700 women) had pre-existing diabetes.
 
Regardless of whether the diabetes was pregnancy-related or pre-existing, the report found that, compared with women without diabetes, those with the condition had higher rates of caesarean section, induced labour, pre-existing and gestational hypertension and pre-eclampsia.
 
These women also had longer hospital stays, before and after delivery.
 
Compared to women with pre-existing diabetes, those with gestational diabetes experienced such complications at a lower rate.
 
And it is not just mothers who experience negative health outcomes associated with diabetes.
 
Babies born to women with pre-existing diabetes also had higher rates of pre-term birth, stillbirth, low and high birthweight, low Apgar scores, a need for resuscitation and special care nursery/neonatal intensive care unit admission, as well as longer stays in hospital.
 
Again, these risks were higher in babies born to mothers with pre-existing diabetes versus those with gestational diabetes.
 
According to the report, these effects were greater in Aboriginal and Torres Strait Islander women with pre-existing diabetes, both in terms of the effect on the mother and her baby. Such effects were also greater in women from remote or very remote regions.
 
A further report released by the AIHW, Improving national reporting on diabetes in pregnancy: technical report, described the national data sources available for monitoring the effects of diabetes in pregnancy on both mothers and babies, including:

  • National Perinatal Data Collective (NPDC)
  • National Hospital Morbidity Database (NHMD)
  • National Diabetes Services Scheme (NDSS).
The report also identified current data gaps, with the aim of improving national monitoring of such information. These gaps included the inability of some states and territories to distinguish between different types of diabetes, and differences in data-collection methods across jurisdictions.
 
According to the RACGP’s General practice management of type 2 diabetes, women with pre-existing diabetes should aim for ‘excellent’ glycaemic control when possible before becoming pregnant. Additionally, all women with pre-existing diabetes should be prescribed high-dose pre-pregnancy folate supplementation up until 12 weeks’ gestation.
 
The RACGP guidelines also state that all pregnant women (without pre-existing diabetes) should be screened for gestational diabetes between 26–28 weeks gestation with a non-fasting glucose challenge. Those at high risk should receive screening at the first opportunity in pregnancy, and if negative, receive repeated screening between 24–28 weeks’ gestation.



AIHW diabetes gestational diabetes pregnancy



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