Primary health care for Aboriginal Australian women in remote communities after a pregnancy with hyperglycaemia
journal contributionposted on 01.04.2021, 05:49 by A Wood, D Mackay, D Fitzsimmons, R Derkenne, R Kirkham, JA Boyle, C Connors, C Whitbread, A Welsh, A Brown, Jonathan Shaw, L Maple-Brown
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Hyperglycaemia in pregnancy contributes to adverse outcomes for women and their children. The postpartum period is an opportune time to support women to reduce cardiometabolic and diabetes risk in subsequent pregnancies. Aims: To identify strengths and gaps in current care for Aboriginal women after a pregnancy complicated by hyperglycaemia. Methods: A retrospective review of the 12 month postpartum care provided by primary health centres in remote Australia in 2013–2014 identified 195 women who experienced hyperglycaemia in pregnancy (gestational diabetes (GDM) (n = 147), type 2 diabetes (T2D) (n = 39), and unclear diabetes status (n = 9)). Results: Only 80 women (54%) with GDM had postpartum glycaemic checks. Of these, 32 women were diagnosed with prediabetes (n = 24) or diabetes (n = 8). Compared to women with GDM, women with T2D were more likely to have their weight measured (75% vs. 52%, p <0.01), and smoking status documented as “discussed” (65% vs. 34%, p < 0.01). Most women (97%) accessed the health centre at least once in the 12 month postpartum period but, during these visits, only 52% of women had service provision, either structured or opportunistic, related to diabetes. Conclusion: High rates of dysglycaemia among women screened for T2D after GDM in the 12 month postpartum period highlight the need for increased screening and early intervention to prevent the development of T2D and its complications. Whilst a clear strength was high postpartum attendance, many women did not attend health services for diabetes screening or management.
This work was funded by Global Alliance Chronic Disease NHMRC Grant #1092968. A.W. is supported by NHMRC Postgraduate Scholarship #1151049. L.M.-B. is supported by NHMRC Practitioner Fellowship #1078477. J.A.B. was supported by NHMRC Career Development Fellowship; A.B. was supported by a Sylvia and Charles Viertel Senior Medical Research Fellowship; J.E.S. was supported by NHMRC Fellowship #1079438.Funding bodies had no role in the study design, in the collection, analysis or interpretation of data, in the writing of the manuscript or the decision to submit the manuscript for publication.
JournalInternational Journal of Environmental Research and Public Health
PublisherMultidisciplinary Digital Publishing Institute (MDPI)
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Science & TechnologyLife Sciences & BiomedicineEnvironmental SciencesPublic, Environmental & Occupational HealthEnvironmental Sciences & Ecologytype 2 diabetesgestational diabetesindigenous healthprimary health careremote health careTYPE-2 DIABETES-MELLITUSGLUCOSE-TOLERANCECONGENITAL-ANOMALIESLOW RATESRISKASSOCIATIONKNOWLEDGEMANITOBAHISTORYHumansDiabetes, GestationalDiabetes Mellitus, Type 2HyperglycemiaRetrospective StudiesPregnancyAdultOceanic Ancestry GroupRural PopulationHealth Services, IndigenousPrimary Health CareDelivery of Health CareAustraliaFemaleYoung AdultToxicology