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Outcomes of Pregnancies Affected by Gestational Diabetes and Type 2 Diabetes in a Rural First Nations Obstetrical Program in Northwest Ontario

Published:January 12, 2020DOI:https://doi.org/10.1016/j.jcjd.2020.01.001

      Abstract

      Objectives

      In this work, we describe diabetes prevalence and birth outcomes in a primarily First Nations obstetrical population in northwest Ontario.

      Methods

      This retrospective, observational study of maternal and neonatal characteristics and birth outcomes was performed at the Sioux Lookout Meno Ya Win Health Centre between April 1, 2012 and March 31, 2017.

      Results

      The prevalence of pre-existing type 2 diabetes mellitus was 3.7% and gestational diabetes mellitus was 7.9%. Mothers with diabetes, compared to those without diabetes, were, on average, 5 years older and were of greater parity. Average prepregnancy weight was higher, with an increased incidence of hypertension, inductions and caesarean sections. Neonates had increased incidence of macrosomia, hypoglycemia and hyperbilirubinemia. All maternal cohorts had high rates of alcohol, tobacco and illicit opioid use.

      Conclusions

      We have identified a high prevalence of diabetes in this First Nations obstetrical population, with associated adverse maternal and neonatal outcomes.

      Résumé

      Objectifs

      Dans le présent ouvrage, nous décrivons la prévalence du diabète et les issues à la naissance dans une population en obstétrique, composée principalement de femmes des Premières Nations du nord-ouest de l’Ontario.

      Méthodes

      Nous avons réalisé cette étude observationnelle rétrospective sur les caractéristiques maternelles et néonatales et les issues à la naissance au Centre de santé Meno Ya Win de Sioux Lookout du 1er avril 2012 au 31 mars 2017.

      Résultats

      La prévalence du diabète sucré préexistant, de type 2 était de 3,7 % et du diabète sucré gestationnel était de 7,9 %. Comparativement aux mères non diabétiques, les mères diabétiques étaient en moyenne âgées de 5 ans de plus et avaient une parité plus élevée. Nous avons observé un poids moyen plus élevé avant la grossesse et une fréquence accrue de l’hypertension, des déclenchements artificiels du travail et des césariennes. Chez les nouveau-nés, nous avons observé une fréquence accrue de la macrosomie, de l’hypoglycémie et de l’hyperbilirubinémie. Toutes les mères des cohortes avaient des taux élevés de consommation d’alcool, de tabac et d’opioïdes illicites.

      Conclusions

      Dans cette population en obstétrique, composée de femmes des Premières Nations, nous avons observé une forte prévalence du diabète, qui était associée à des issues maternelles et néonatales défavorables.

      Keywords

      Mots clés

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