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Alwash SM, Huda MM, McIntyre HD, Mamun AA. Time trends and projections in the prevalence of gestational diabetes mellitus in Queensland, Australia, 2009-2030: Evidence from the Queensland Perinatal Data Collection. Aust N Z J Obstet Gynaecol 2023; 63:811-820. [PMID: 37435791 DOI: 10.1111/ajo.13734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is the fastest-growing type of diabetes in Australia. We aimed to assess the time trends during 2009-2018 and projections of GDM in Queensland, Australia up to 2030. MATERIALS AND METHODS The study data were from the Queensland Perinatal Data Collection (QPDC) and included data on 606 662 birth events with the births reported from at least 20 weeks gestational age or birth weight at least 400 g. Bayesian regression model was used to assess the trends in the prevalence of GDM. RESULTS The prevalence of GDM increased from 5.47 to 13.62% from 2009 to 2018 (average annual rate of change, AARC = +10.71%). If the trend remains the same, the projected prevalence will increase to 42.04% (95% uncertainty interval = 34.77-48.96) by 2030. Observing AARC across different subpopulations, we found that the trend of GDM increased markedly among women living in inner regional areas (AARC = +12.49%), were non-Indigenous (AARC = +10.93%), most disadvantaged (AARC = +11.84%), aged either of two age groups (AARC = +18.45% and + 15.17% for <20 years and 20-24 years, respectively), were with obesity (AARC = +11.05%) and smoked during pregnancy (AARC = +12.26%). CONCLUSIONS Overall, the prevalence of GDM has sharply increased in Queensland, and if this trend continues, about 42% of pregnant women will experience GDM by 2030. The trends vary across different subpopulations. Therefore, targeting the most vulnerable subpopulations is vital to prevent the development of GDM.
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Affiliation(s)
- Sura M Alwash
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
| | - M Mamun Huda
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families Over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
| | - H David McIntyre
- Mater Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Abdullah A Mamun
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
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Hegerty C, Ostini R. Benefits and harms associated with an increase in gestational diabetes diagnosis in Queensland, Australia: a retrospective cohort comparison of diagnosis rates, outcomes, interventions and medication use for two periods, 2011-2013 and 2016-2018, using a large perinatal database. BMJ Open 2023; 13:e069849. [PMID: 37192791 DOI: 10.1136/bmjopen-2022-069849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVES To assess benefits and harms arising from increasing gestational diabetes (GDM) diagnosis, including for women with normal-sized babies. DESIGN, SETTING AND PARTICIPANTS Diagnosis rates, outcomes, interventions and medication use are compared in a retrospective cohort study of 229 757 women birthing in public hospitals of the Australian State of Queensland during two periods, 2011-2013 and 2016-2018, using data from the Queensland Perinatal Data Collection. OUTCOME MEASURES Comparisons include hypertensive disorders, caesarean section, shoulder dystocia and associated harm, induction of labour (IOL), planned birth (PB), early planned birth <39 weeks (EPB), spontaneous labour onset with vaginal birth (SLVB) and medication use. RESULTS GDM diagnosis increased from 7.8% to 14.3%. There was no improvement in shoulder dystocia associated injuries, hypertensive disorders or caesarean sections. There was an increase in IOL (21.8%-30.0%; p<0.001), PB (36.3% to 46.0%; p<0.001) and EPB (13.5%-20.6%; p<0.001), and a decrease in SLVB (56.0%-47.3%; p<0.001). Women with GDM experienced an increase in IOL (40.9%-49.8%; p<0.001), PB (62.9% to 71.8%; p<0.001) and EPB (35.3%-45.7%; p<0.001), and a decrease in SLVB (30.01%-23.6%; p<0.001), with similar changes for mothers with normal-sized babies. Of women prescribed insulin in 2016-2018, 60.4% experienced IOL, 88.5% PB, 76.4% EPB and 8.0% SLVB. Medication use increased from 41.2% to 49.4% in women with GDM, from 3.2% to 7.1% in the antenatal population overall, from 3.3% to 7.5% in women with normal-sized babies and from 2.21% to 4.38% with babies less than the 10th percentile. CONCLUSION Outcomes were not apparently improved with increased GDM diagnosis. The merits of increased IOL or decreased SLVB depend on the views of individual women, but categorising more pregnancies as abnormal, and exposing more babies to the potential effects of early birth, medication effects and growth limitation may be harmful.
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Affiliation(s)
- Christopher Hegerty
- Warwick Hospital, Queensland Health, Warwick, Queensland, Australia
- General Rural Medicine, Queensland Government Department of Health and Ageing, Warwick, Queensland, Australia
| | - Remo Ostini
- Rural Clinical School Research Centre, University of Queensland School of Medicine, Toowoomba, Queensland, Australia
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Shi P, Tang J, Yin X. Association between second- and third-trimester maternal lipid profiles and adverse perinatal outcomes among women with GDM and non-GDM: a retrospective cohort study. BMC Pregnancy Childbirth 2023; 23:318. [PMID: 37147564 PMCID: PMC10161404 DOI: 10.1186/s12884-023-05630-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 04/20/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Lipid metabolism disorder during pregnancy has been reported in women with gestational diabetes mellitus (GDM). However, controversy remains regarding the relationship between maternal changes in lipid profiles and perinatal outcomes. This study investigated the association between maternal lipid levels and adverse perinatal outcomes in women with GDM and non-GDM. METHODS In total, 1632 pregnant women with GDM and 9067 women with non-GDM who delivered between 2011-2021 were enrolled in this study. Serum samples were assayed for fasting total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels during the second and third trimesters of pregnancy. Adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) were calculated via multivariable logistic regression analysis to determine the association of lipid levels with perinatal outcomes. RESULTS The serum TC, TG, LDL, and HDL levels in the third trimester were significantly higher than those in the second trimester (p < 0.001). Women with GDM had significantly higher levels of TC and TG in the second and third trimesters than those with non-GDM in the same trimesters, while HDL levels decreased in women with GDM (all p < 0.001). After adjusting for confounding factors by multivariate logistic regression, every mmol/L elevation in TG levels of women with GDM in second and third trimesters was associated with a higher risk of caesarean section (AOR = 1.241, 95% CI: 1.103-1.396, p < 0.001; AOR = 1.716, 95% CI: 1.556-1.921, p < 0.001), large for gestational age infants (LGA) (AOR = 1.419, 95% CI: 1.173-2.453, p = 0.001; AOR = 2.011, 95% CI: 1.673-2.735, p < 0.001), macrosomia (AOR = 1.220, 95% CI: 1.133-1.643, p = 0.005; AOR = 1.891, 95% CI: 1.322-2.519, p < 0.001), and neonatal unit admission (NUD; AOR = 1.781, 95% CI: 1.267-2.143, p < 0.001; AOR = 2.052, 95% CI: 1.811-2.432, p < 0.001) cesarean delivery (AOR = 1.423, 95% CI: 1.215-1.679, p < 0.001; AOR = 1.834, 95% CI: 1.453-2.019, p < 0.001), LGA (AOR = 1.593, 95% CI: 1.235-2.518, p = 0.004; AOR = 2.326, 95% CI: 1.728-2.914, p < 0.001), macrosomia (AOR = 1.346, 95% CI: 1.209-1.735, p = 0.006; AOR = 2.032, 95% CI: 1.503-2.627, p < 0.001), and neonatal unit admission (NUD) (AOR = 1.936, 95% CI: 1.453-2.546, p < 0.001; AOR = 1.993, 95% CI: 1.724-2.517, p < 0.001), which were higher than the relative risk of these perinatal outcomes in women with non-GDM. Additionally, every mmol/L increase in second and third-trimester HDL levels of women with GDM was associated with decreased risk of LGA(AOR = 0.421, 95% CI: 0.353-0.712, p = 0.007; AOR = 0.525, 95% CI: 0.319-0.832, p = 0.017) and NUD (AOR = 0.532, 95% CI: 0.327-0.773, p = 0.011; AOR = 0.319, 95% CI: 0.193-0.508, p < 0.001), and the risk reduction was not strong than that of women with GDM. CONCLUSIONS Among women with GDM, high maternal TG in the second and third trimesters was independently associated with an increased risk of cesarean section, LGA, macrosomia, and NUD. High maternal HDL during the second and third trimesters was significantly associated with decreased risk of LGA and NUD. These associations were stronger than those in women with non-GDM, suggesting the importance of monitoring second and third-trimester lipid profiles in improving clinical outcomes, especially in GDM pregnancies.
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Affiliation(s)
- Ping Shi
- Wujin Hospital Affiliated With Jiangsu University, Changzhou, Jiangsu, China
- The Wujin Clinical College of Xuzhou Medical University, No 2 Yongning North Road, Tianning District, Changzhou, Jiangsu, China
| | - Jie Tang
- Wujin Hospital Affiliated With Jiangsu University, Changzhou, Jiangsu, China
- The Wujin Clinical College of Xuzhou Medical University, No 2 Yongning North Road, Tianning District, Changzhou, Jiangsu, China
| | - Xiaoyan Yin
- Wujin Hospital Affiliated With Jiangsu University, Changzhou, Jiangsu, China.
- The Wujin Clinical College of Xuzhou Medical University, No 2 Yongning North Road, Tianning District, Changzhou, Jiangsu, China.
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Yang Y, Wu N. Gestational Diabetes Mellitus and Preeclampsia: Correlation and Influencing Factors. Front Cardiovasc Med 2022; 9:831297. [PMID: 35252402 PMCID: PMC8889031 DOI: 10.3389/fcvm.2022.831297] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/20/2022] [Indexed: 12/16/2022] Open
Abstract
Gestational diabetes mellitus (GDM) and preeclampsia (PE) are common pregnancy complications with similar risk factors and pathophysiological changes. Evidence from previous studies suggests that the incidence of PE is significantly increased in women with GDM, but whether GDM is independently related to the occurrence of PE has remained controversial. GDM complicated by PE further increases perinatal adverse events with greater impact on the future maternal and offspring health. Identify factors associated with PE in women with GDM women, specifically those that are controllable, is important for improving pregnancy outcomes. This paper provides the findings of a review on the correlation between GDM and PE, factors associated with PE in women with GDM, possible mechanisms, and predictive markers. Most studies concluded that GDM is independently associated with PE in singleton pregnancy, and optimizing the treatment and management of GDM can reduce the incidence of PE, which is very helpful to improve pregnancy outcomes.
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Affiliation(s)
- Ying Yang
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Na Wu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Skills Practice Teaching Center, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Na Wu
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Banyeh M, Amidu N, Quaye L. The relationship between offspring's 2D:4D ratio and postpartum maternal circulating testosterone, estradiol, and their indices in a Ghanaian population. Am J Hum Biol 2021; 34:e23684. [PMID: 34558765 DOI: 10.1002/ajhb.23684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The 2D:4D ratio is influenced by prenatal testosterone (PT) and estrogen (PE) exposure in utero. This study sought to determine whether evidence of Manning's hypothesis can still be observed even in the postpartum period. We hypothesize that the offspring 2D:4D ratios will be inversely correlated with maternal postpartum circulating testosterone but positively correlated with estradiol. METHODS This study was conducted between December 2020 and April 2021 and was cross-sectional in nature. There were 272 mother-offspring pairs; the mothers were aged between 18 and 36 years while the median (IQR) age of their offspring was 111 (44-210) days. Offspring right (2D:4DR) and left (2D:4DL) digit ratios were measured using computer-assisted analysis. Sampling was done at 111 (44-210) days postpartum and blood was analyzed for total testosterone (TT), estradiol (E2) and sex hormone-binding globulins using the enzyme-linked immunosorbent assay technique. RESULTS The 2D:4DR of sons was significantly lower compared to daughters (p = .031). Mothers with sons had significantly increased levels of serum TT (p = .001) while mothers with daughters had significantly increased levels of E2 (p = .000). As hypothesized, the maternal serum free testosterone (FT%) was inversely correlated with their daughters' (r = -0.320, p = .003), and also with their sons' (r = -0.213, p = .047), 2D:4DL. Unexpectedly, daughters' 2D:4DL was inversely correlated with maternal circulating free E2 (r = -0.255, p = .015). CONCLUSIONS In humans, evidence of the relationship between maternal testosterone levels and their offspring's 2D:4D ratio may persist even into the postpartum period.
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Affiliation(s)
- Moses Banyeh
- Department of Biomedical Laboratory Science, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Nafiu Amidu
- Department of Biomedical Laboratory Science, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Lawrence Quaye
- Department of Biomedical Laboratory Science, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
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Yuen L, Wong VW, Wolmarans L, Simmons D. Comparison of Pregnancy Outcomes Using Different Gestational Diabetes Diagnostic Criteria and Treatment Thresholds in Multiethnic Communities between Two Tertiary Centres in Australian and New Zealand: Do They Make a Difference? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094588. [PMID: 33926029 PMCID: PMC8123706 DOI: 10.3390/ijerph18094588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/16/2021] [Accepted: 04/21/2021] [Indexed: 11/24/2022]
Abstract
Introduction: Australia, but not New Zealand (NZ), has adopted the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria to diagnose gestational diabetes (GDM). We compared pregnancy outcomes using these different diagnostic approaches. Method: Prospective data of women with GDM were collected from one NZ (NZ) and one Australian (Aus) hospital between 2007–2018. Aus screening criteria with 2-step risk-based 50 g Glucose Challenge Testing (GCT) followed by 75 g-oral glucose tolerance testing (OGTT): fasting ≥ 5.5, 2-h ≥ 8.0 mmol/L (ADIPS98) changed to a universal OGTT and fasting ≥5.1, 1-h ≥ 10, 2-h ≥ 8.5 mmol/L (IADPSG). NZ used GCT followed by OGTT with fasting ≥ 5.5, 2-h ≥ 9.0 mmol/L (NZSSD); in 2015 adopted a booking HbA1c (NZMOH). Primary outcome was a composite of macrosomia, perinatal death, preterm delivery, neonatal hypoglycaemia, and phototherapy. An Aus subset positive using NZSSD was also defined. RESULTS: The composite outcome odds ratio compared to IADPSG (1788 pregnancies) was higher for NZMOH (934 pregnancies) 2.227 (95%CI: 1.84–2.68), NZSSD (1344 pregnancies) 2.19 (1.83–2.61), and ADIPS98 (3452 pregnancies) 1.91 (1.66–2.20). Composite outcomes were similar between the Aus subset and NZ. Conclusions: The IADPSG diagnostic criteria were associated with the lowest rate of composite outcomes. Earlier NZ screening with HbA1c was not associated with a change in adverse pregnancy outcomes.
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Affiliation(s)
- Lili Yuen
- School of Medicine and the Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia;
- Correspondence: ; Tel.: +612-4620-3899; Fax: +612-4620-3890
| | - Vincent W. Wong
- South Western Sydney Clinical School, University of New South Wales, Liverpool, NSW 2170, Australia;
- Diabetes and Endocrine Service, Liverpool Hospital, Liverpool, NSW 2170, Australia
| | | | - David Simmons
- School of Medicine and the Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia;
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Panaitescu AM, Ciobanu AM, Popa M, Duta I, Gica N, Peltecu G, Veduta A. Screening for Gestational Diabetes during the COVID-19 Pandemic-Current Recommendations and Their Consequences. ACTA ACUST UNITED AC 2021; 57:medicina57040381. [PMID: 33920937 PMCID: PMC8071285 DOI: 10.3390/medicina57040381] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/07/2021] [Accepted: 04/13/2021] [Indexed: 01/11/2023]
Abstract
Gestational diabetes mellitus (GDM) is recognized as one of the most common medical complications of pregnancy that can lead to significant short-term and long-term risks for the mother and the fetus if not detected early and treated appropriately. Current evidence suggests that, with the use of appropriate screening programs for GDM, those women diagnosed and treated have reduced perinatal morbidity. It has been implied that, when screening for GDM, there should be uniformity in the testing used and in further management. This paper summarizes and compares current screening strategies proposed by international bodies and discusses application in the context of the COVID-19 pandemic.
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Affiliation(s)
- Anca Maria Panaitescu
- Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (N.G.); (G.P.)
- Filantropia Clinical Hospital, 11171 Bucharest, Romania; (M.P.); (A.V.)
- Correspondence: ; Tel.: +40-2318-8930
| | - Anca Marina Ciobanu
- Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (N.G.); (G.P.)
- Filantropia Clinical Hospital, 11171 Bucharest, Romania; (M.P.); (A.V.)
| | - Maria Popa
- Filantropia Clinical Hospital, 11171 Bucharest, Romania; (M.P.); (A.V.)
| | - Irina Duta
- Endocrinology and Diabetes, Southend University Hospital, Essex SS0 0RYUK, UK;
| | - Nicolae Gica
- Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (N.G.); (G.P.)
- Filantropia Clinical Hospital, 11171 Bucharest, Romania; (M.P.); (A.V.)
| | - Gheorghe Peltecu
- Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (N.G.); (G.P.)
- Filantropia Clinical Hospital, 11171 Bucharest, Romania; (M.P.); (A.V.)
| | - Alina Veduta
- Filantropia Clinical Hospital, 11171 Bucharest, Romania; (M.P.); (A.V.)
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Baldwin HJ, Nippita TA, Rickard K, Torvaldsen S, McGee TM, Patterson JA. Reporting of gestational diabetes and other maternal medical conditions: validation of routinely collected hospital data from New South Wales, Australia. Int J Popul Data Sci 2021; 6:1381. [PMID: 34007895 PMCID: PMC8103993 DOI: 10.23889/ijpds.v6i1.1381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Introduction Hospital datasets are a valuable resource for examining prevalence and outcomes of medical conditions during pregnancy. To enable effective research and health planning, it is important to determine whether variables are reliably captured. Objective To examine the reliability of reporting of gestational and pre-existing diabetes, hypertension, thyroid conditions, and morbid obesity in coded hospital records that inform the population-level New South Wales Admitted Patient Data Collection. Methods Coded hospital admission data from two large tertiary hospitals in New South Wales, from 2011 to 2015, were compared with obstetric data, collected by midwives at outpatient pregnancy booking and in hospital after birth, as the reference standard. Records were deterministically linked and sensitivity, specificity, positive predictive values and negative predictive values for the conditions of interest were obtained. Results There were 36,051 births included in the analysis. Sensitivity was high for gestational diabetes (83.6%, 95% CI 82.4–84.7%), pre-existing diabetes (88.2%, 95% CI 84.1–91.6%), and gestational hypertension (80.1%, 95% CI 78.2–81.9%), moderate for chronic hypertension (53.5%, 95% CI 47.8–59.1%), and low for thyroid conditions (12.9%, 95% CI 11.7–14.2%) and morbid obesity (9.8%, 95% CI 7.6–12.4%). Specificity was high for all conditions (≥97.8%, 95% CI 97.7–98.0) and positive predictive value ranged from 53.2% for chronic hypertension (95% CI 47.5–58.8%) to 92.7% for gestational diabetes (95% CI 91.8–93.5%). Conclusion Our findings suggest that coded hospital data are a reliable source of information for gestational and pre-existing diabetes and gestational hypertension. Chronic hypertension is less consistently reported, which may be remedied by grouping hypertension types. Data on thyroid conditions and morbid obesity should be used with caution, and if possible, other sources of data for those conditions should be sought.
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Affiliation(s)
- Heather J Baldwin
- The University of Sydney Northern Clinical School, Women and Babies Research, NSW, Australia; Northern Sydney Local Health District, Kolling Institute, Australia
| | - Tanya A Nippita
- The University of Sydney Northern Clinical School, Women and Babies Research, NSW, Australia; Northern Sydney Local Health District, Kolling Institute, Australia.,Department of Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards, Australia
| | - Kristen Rickard
- The University of Sydney Northern Clinical School, Women and Babies Research, NSW, Australia; Northern Sydney Local Health District, Kolling Institute, Australia.,Department of Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards, Australia
| | - Siranda Torvaldsen
- The University of Sydney Northern Clinical School, Women and Babies Research, NSW, Australia; Northern Sydney Local Health District, Kolling Institute, Australia.,Department of Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards, Australia.,School of Public Health and Community Medicine, UNSW, Australia
| | - Therese M McGee
- OG Department, Clinical Support Unit, Level 3, G Block, Westmead Hospital, Westmead, Australia; The University of Sydney Westmead Clinical School, NSW, Australia
| | - Jillian A Patterson
- The University of Sydney Northern Clinical School, Women and Babies Research, NSW, Australia; Northern Sydney Local Health District, Kolling Institute, Australia
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Laurie JG, McIntyre HD. A Review of the Current Status of Gestational Diabetes Mellitus in Australia-The Clinical Impact of Changing Population Demographics and Diagnostic Criteria on Prevalence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9387. [PMID: 33333879 PMCID: PMC7765268 DOI: 10.3390/ijerph17249387] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 12/12/2022]
Abstract
The current status of gestational diabetes mellitus in Australia reveals an almost quadrupling prevalence over the last decade. A narrative review of the current Australian literature reveals unique challenges faced by Australian maternity clinicians when addressing this substantial disease burden in our diverse population. Rising rates of maternal overweight and obesity, increasing maternal age and the diversity of ethnicity are key epidemiological impactors, overlaid by the 2015 changes in screening and diagnostic parameters. Our vast land mass and the remote location of many at risk women requires innovative and novel ideas for pathways to diagnose and effectively manage women with gestational diabetes mellitus. By modifying and modernizing models of care for women with gestational diabetes mellitus, we have the ability to address accessibility, resource management and our acute response to global events such as the COVID 19 pandemic. With continuing research, education and robust discourse, Australia is well placed to meet current and future challenges in the management of gestational diabetes mellitus.
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Affiliation(s)
- Josephine G Laurie
- Department of Obstetric Medicine, Mater Mothers’ Hospital Brisbane, Queensland and Mater Clinical Unit, The University of Queensland, South Brisbane, QLD 4101, Australia
| | - H. David McIntyre
- Department of Obstetric Medicine, Mater Mothers’ Hospital Brisbane, Queensland and Mater Research Institute, The University of Queensland, South Brisbane, QLD 4101, Australia;
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Paschou SA, Sydney GI, Ioakim KJ, Kotsa K, Goulis DG. Comment on the systematic review and meta-analysis titled "Gestational diabetes and the risk of cardiovascular disease in women". Hormones (Athens) 2020; 19:447-448. [PMID: 31713724 DOI: 10.1007/s42000-019-00158-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 11/05/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Stavroula A Paschou
- Division of Endocrinology and Diabetes, "Aghia Sophia" Hospital, Medical School, National and Kapodistrian University of Athens, Thivon and Papadiamantopoulou, 11527, Athens, Greece.
- School of Medicine, European University Cyprus, Nicosia, Cyprus.
| | - Guy I Sydney
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | | | - Kalliopi Kotsa
- Division of Endocrinology and Metabolism, Diabetes Centre, First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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