Social and economic factors, maternal behaviours in pregnancy and neonatal adiposity in the PANDORA cohort

PANDORA study research team, Danielle Krista Longmore, Elizabeth Laurel Mary Barr, Federica Barzi, I-Lynn Lee, Marie Kirkwood, Christine Connors, Jacqueline Boyle, Kerin O'dea, Paul Zimmet, Jeremy Oats, Patrick Catalano, H David Mcintyre, Alex D H Brown, Jonathan E Shaw, Louise J Maple-Brown

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Australian Indigenous women experience high rates of social disadvantage and type 2 diabetes (T2D) in pregnancy, but it is not known how social factors and maternal behaviours impact neonatal adiposity in offspring of women with hyperglycaemia in pregnancy.

METHODS: Participants were Indigenous (n=404) and Europid (n=240) women with gestational diabetes mellitus (GDM) or T2D in pregnancy and their offspring in the Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study. Social, economic factors, and maternal behaviours were measured in pregnancy and six neonatal anthropometric outcomes were examined after birth.

RESULTS: On univariate analysis, maternal education <12 years (p=0.03), unemployment (p=0.001), welfare income vs no welfare income (p=0.001), lower area based socio-economic score (p<0.001), and fast food intake >2 times/week (p=0.002) were associated with increased sum of skinfolds (SSF) in offspring. Smoking was significantly associated with a reduction in anthropometric measures, except SSF. In multivariable models adjusted for ethnicity, BMI and hyperglycaemia, social and economic factors were no longer significant predictors of neonatal outcomes. Smoking was independently associated with a reduction in length, head circumference and fat free mass. Frequent fast food intake remained independently associated with SSF (β-coefficient 1.08mm, p=0.02).

CONCLUSION: In women with hyperglycaemia in pregnancy, social factors were associated with neonatal adiposity, particularly skinfold measures. Promoting smoking cessation and limited intake of energy-dense, nutrient-poor foods in pregnancy are important to improve neonatal adiposity and lean mass outcomes. Addressing inequities in social and economic factors are likely to be important, particularly for Indigenous women or women experiencing social disadvantage.

LanguageEnglish
Pages108028
JournalDiabetes Research and Clinical Practice
DOIs
Publication statusE-pub ahead of print - 18 Jan 2020
Externally publishedYes

Keywords

  • diabetes
  • indigenous
  • hyperglycaemia in pregnancy
  • Neonatal adiposity
  • Socio-economic

Cite this

@article{61340bac22ef483ba5bb1e659a980e78,
title = "Social and economic factors, maternal behaviours in pregnancy and neonatal adiposity in the PANDORA cohort",
abstract = "BACKGROUND: Australian Indigenous women experience high rates of social disadvantage and type 2 diabetes (T2D) in pregnancy, but it is not known how social factors and maternal behaviours impact neonatal adiposity in offspring of women with hyperglycaemia in pregnancy.METHODS: Participants were Indigenous (n=404) and Europid (n=240) women with gestational diabetes mellitus (GDM) or T2D in pregnancy and their offspring in the Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study. Social, economic factors, and maternal behaviours were measured in pregnancy and six neonatal anthropometric outcomes were examined after birth.RESULTS: On univariate analysis, maternal education <12 years (p=0.03), unemployment (p=0.001), welfare income vs no welfare income (p=0.001), lower area based socio-economic score (p<0.001), and fast food intake >2 times/week (p=0.002) were associated with increased sum of skinfolds (SSF) in offspring. Smoking was significantly associated with a reduction in anthropometric measures, except SSF. In multivariable models adjusted for ethnicity, BMI and hyperglycaemia, social and economic factors were no longer significant predictors of neonatal outcomes. Smoking was independently associated with a reduction in length, head circumference and fat free mass. Frequent fast food intake remained independently associated with SSF (β-coefficient 1.08mm, p=0.02).CONCLUSION: In women with hyperglycaemia in pregnancy, social factors were associated with neonatal adiposity, particularly skinfold measures. Promoting smoking cessation and limited intake of energy-dense, nutrient-poor foods in pregnancy are important to improve neonatal adiposity and lean mass outcomes. Addressing inequities in social and economic factors are likely to be important, particularly for Indigenous women or women experiencing social disadvantage.",
keywords = "diabetes, indigenous, hyperglycaemia in pregnancy, Neonatal adiposity, Socio-economic",
author = "{PANDORA study research team} and {Krista Longmore}, Danielle and {Laurel Mary Barr}, Elizabeth and Federica Barzi and I-Lynn Lee and Marie Kirkwood and Christine Connors and Jacqueline Boyle and Kerin O'dea and Paul Zimmet and Jeremy Oats and Patrick Catalano and {David Mcintyre}, H and Brown, {Alex D H} and Shaw, {Jonathan E} and Maple-Brown, {Louise J}",
note = "Copyright {\circledC} 2020. Published by Elsevier B.V.",
year = "2020",
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Social and economic factors, maternal behaviours in pregnancy and neonatal adiposity in the PANDORA cohort. / PANDORA study research team.

In: Diabetes Research and Clinical Practice, 18.01.2020, p. 108028.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Social and economic factors, maternal behaviours in pregnancy and neonatal adiposity in the PANDORA cohort

AU - PANDORA study research team

AU - Krista Longmore, Danielle

AU - Laurel Mary Barr, Elizabeth

AU - Barzi, Federica

AU - Lee, I-Lynn

AU - Kirkwood, Marie

AU - Connors, Christine

AU - Boyle, Jacqueline

AU - O'dea, Kerin

AU - Zimmet, Paul

AU - Oats, Jeremy

AU - Catalano, Patrick

AU - David Mcintyre, H

AU - Brown, Alex D H

AU - Shaw, Jonathan E

AU - Maple-Brown, Louise J

N1 - Copyright © 2020. Published by Elsevier B.V.

PY - 2020/1/18

Y1 - 2020/1/18

N2 - BACKGROUND: Australian Indigenous women experience high rates of social disadvantage and type 2 diabetes (T2D) in pregnancy, but it is not known how social factors and maternal behaviours impact neonatal adiposity in offspring of women with hyperglycaemia in pregnancy.METHODS: Participants were Indigenous (n=404) and Europid (n=240) women with gestational diabetes mellitus (GDM) or T2D in pregnancy and their offspring in the Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study. Social, economic factors, and maternal behaviours were measured in pregnancy and six neonatal anthropometric outcomes were examined after birth.RESULTS: On univariate analysis, maternal education <12 years (p=0.03), unemployment (p=0.001), welfare income vs no welfare income (p=0.001), lower area based socio-economic score (p<0.001), and fast food intake >2 times/week (p=0.002) were associated with increased sum of skinfolds (SSF) in offspring. Smoking was significantly associated with a reduction in anthropometric measures, except SSF. In multivariable models adjusted for ethnicity, BMI and hyperglycaemia, social and economic factors were no longer significant predictors of neonatal outcomes. Smoking was independently associated with a reduction in length, head circumference and fat free mass. Frequent fast food intake remained independently associated with SSF (β-coefficient 1.08mm, p=0.02).CONCLUSION: In women with hyperglycaemia in pregnancy, social factors were associated with neonatal adiposity, particularly skinfold measures. Promoting smoking cessation and limited intake of energy-dense, nutrient-poor foods in pregnancy are important to improve neonatal adiposity and lean mass outcomes. Addressing inequities in social and economic factors are likely to be important, particularly for Indigenous women or women experiencing social disadvantage.

AB - BACKGROUND: Australian Indigenous women experience high rates of social disadvantage and type 2 diabetes (T2D) in pregnancy, but it is not known how social factors and maternal behaviours impact neonatal adiposity in offspring of women with hyperglycaemia in pregnancy.METHODS: Participants were Indigenous (n=404) and Europid (n=240) women with gestational diabetes mellitus (GDM) or T2D in pregnancy and their offspring in the Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study. Social, economic factors, and maternal behaviours were measured in pregnancy and six neonatal anthropometric outcomes were examined after birth.RESULTS: On univariate analysis, maternal education <12 years (p=0.03), unemployment (p=0.001), welfare income vs no welfare income (p=0.001), lower area based socio-economic score (p<0.001), and fast food intake >2 times/week (p=0.002) were associated with increased sum of skinfolds (SSF) in offspring. Smoking was significantly associated with a reduction in anthropometric measures, except SSF. In multivariable models adjusted for ethnicity, BMI and hyperglycaemia, social and economic factors were no longer significant predictors of neonatal outcomes. Smoking was independently associated with a reduction in length, head circumference and fat free mass. Frequent fast food intake remained independently associated with SSF (β-coefficient 1.08mm, p=0.02).CONCLUSION: In women with hyperglycaemia in pregnancy, social factors were associated with neonatal adiposity, particularly skinfold measures. Promoting smoking cessation and limited intake of energy-dense, nutrient-poor foods in pregnancy are important to improve neonatal adiposity and lean mass outcomes. Addressing inequities in social and economic factors are likely to be important, particularly for Indigenous women or women experiencing social disadvantage.

KW - diabetes

KW - indigenous

KW - hyperglycaemia in pregnancy

KW - Neonatal adiposity

KW - Socio-economic

U2 - 10.1016/j.diabres.2020.108028

DO - 10.1016/j.diabres.2020.108028

M3 - Article

SP - 108028

JO - Diabetes Research and Clinical Practice

T2 - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

SN - 0168-8227

ER -