Primary health care for aboriginal australian women in remote communities after a pregnancy with hyperglycaemia

Anna Wood, Diana Mackay, Dana Fitzsimmons, Ruth Derkenne, Renae Kirkham, Jacqueline A. Boyle, Christine Connors, Cherie Whitbread, Alison Welsh, Alex Brown, Jonathan E. Shaw, Louise Maple-Brown

Research output: Contribution to journalArticle

Abstract

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.

LanguageEnglish
Article number720
JournalInternational journal of environmental research and public health
Volume17
Issue number3
DOIs
Publication statusPublished - 1 Feb 2020

Keywords

  • Gestational diabetes
  • Indigenous health
  • Primary health care
  • Remote health care
  • Type 2 diabetes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Cite this

Wood, Anna ; Mackay, Diana ; Fitzsimmons, Dana ; Derkenne, Ruth ; Kirkham, Renae ; Boyle, Jacqueline A. ; Connors, Christine ; Whitbread, Cherie ; Welsh, Alison ; Brown, Alex ; Shaw, Jonathan E. ; Maple-Brown, Louise. / Primary health care for aboriginal australian women in remote communities after a pregnancy with hyperglycaemia. In: International journal of environmental research and public health. 2020 ; Vol. 17, No. 3.
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abstract = "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.",
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Wood, A, Mackay, D, Fitzsimmons, D, Derkenne, R, Kirkham, R, Boyle, JA, Connors, C, Whitbread, C, Welsh, A, Brown, A, Shaw, JE & Maple-Brown, L 2020, 'Primary health care for aboriginal australian women in remote communities after a pregnancy with hyperglycaemia', International journal of environmental research and public health, vol. 17, no. 3, 720. https://doi.org/10.3390/ijerph17030720

Primary health care for aboriginal australian women in remote communities after a pregnancy with hyperglycaemia. / Wood, Anna; Mackay, Diana; Fitzsimmons, Dana; Derkenne, Ruth; Kirkham, Renae; Boyle, Jacqueline A.; Connors, Christine; Whitbread, Cherie; Welsh, Alison; Brown, Alex; Shaw, Jonathan E.; Maple-Brown, Louise.

In: International journal of environmental research and public health, Vol. 17, No. 3, 720, 01.02.2020.

Research output: Contribution to journalArticle

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T1 - Primary health care for aboriginal australian women in remote communities after a pregnancy with hyperglycaemia

AU - Wood, Anna

AU - Mackay, Diana

AU - Fitzsimmons, Dana

AU - Derkenne, Ruth

AU - Kirkham, Renae

AU - Boyle, Jacqueline A.

AU - Connors, Christine

AU - Whitbread, Cherie

AU - Welsh, Alison

AU - Brown, Alex

AU - Shaw, Jonathan E.

AU - Maple-Brown, Louise

PY - 2020/2/1

Y1 - 2020/2/1

N2 - 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.

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KW - Indigenous health

KW - Primary health care

KW - Remote health care

KW - Type 2 diabetes

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JF - International Journal of Environmental Research and Public Health

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