Systematic Reviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jun 25, 2015; 6(6): 880-888
Published online Jun 25, 2015. doi: 10.4239/wjd.v6.i6.880
Pregnancy and neonatal outcomes in Indigenous Australians with diabetes in pregnancy
Victor Duong, Bronwyn Davis, Henrik Falhammar
Victor Duong, Royal Darwin Hospital, Tiwi NT 0810, Australia
Bronwyn Davis, Centre for Nursing and Midwifery Research, College of Healthcare Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville City QLD 4811, Australia
Henrik Falhammar, Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, 171 76 Solna, Sweden
Henrik Falhammar, Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76 Solna, Sweden
Henrik Falhammar, Menzies School of Health Research, Royal Darwin Hospital, Tiwi NT 0810, Australia
Author contributions: Duong V, Davis B and Falhammar H equally contributed to this paper.
Supported by Magn Bergvalls Foundation, Karolinska Institutet and Stockholm County Council.
Conflict-of-interest: The authors have no conflicts of interest.
Data sharing: Not applicable.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Victor Duong, BBiomedSc, MBBS, Royal Darwin Hospital, 105 Rocklands Drive, Tiwi NT 0810, Australia.
Telephone: +61-8-89228888
Received: November 26, 2014
Peer-review started: November 28, 2014
First decision: January 20, 2015
Revised: March 17, 2015
Accepted: April 27, 2015
Article in press: April 29, 2015
Published online: June 25, 2015

AIM: To perform a systematic review of reported neonatal and pregnancy outcomes of Indigenous Australians with diabetes in pregnancy (DIP).

METHODS: Electronic searches of PubMed and Web of Science were carried out. Articles were selected if they contained original data on DIP outcomes in Indigenous Australians. There were no specific exclusion criteria.

RESULTS: A total of eight articles, predominantly from Queensland and Western Australia were identified once inclusion criteria were applied. Birth data from midwifery registries or paper charts encompassing years 1985-2008 were used. A total of 465591 pregnant women with and without DIP were included in the eight studies, with 1363 being Indigenous women with DIP. Indigenous Australians experienced increased rates of many known adverse outcomes of DIP including: macrosomia, caesarean section, congenital deformities, low birth weight, hypoglycaemia, and neonatal trauma. There were regional differences among Indigenous Australians, particularly regional/remote vs metropolitan populations where the regional/remote data showed worse outcomes. Two of the articles did not note a difference between Aboriginals and Caucasians in the rates of measured adverse outcome. Studies varied significantly in size, measured outcomes, and subsequent analysis.

CONCLUSION: The health disparities between Indigenous Australians and non-Indigenous Australians are further evidenced by poorer outcomes in DIP. This has broader implications for Indigenous health in general.

Keywords: Diabetes, Gestational, Hyperglycaemia, Pregnancy, Indigenous, Aboriginal, Torres Strait Islander, Outcomes

Core tip: A review of all published data in Australia concerning diabetes in pregnancy outcomes in Indigenous Australians was performed. Of the eight articles identified, Indigenous Australians were shown to have higher rates of adverse outcomes compared to the non-Indigenous population. Living in a remote region appeared to increase the risk of an adverse outcome. This article highlights further health disparities between Indigenous and non-Indigenous, but also exposes gaps in regional data.