Gestational diabetes is associated with postpartum hemorrhage in Indigenous Australian women in the PANDORA study: A prospective cohort.
Indigenous population
antenatal care
hyperglycemia in pregnancy
population health
postpartum hemorrhage
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
revised:
28
07
2021
received:
19
05
2021
accepted:
28
07
2021
pubmed:
31
7
2021
medline:
21
10
2021
entrez:
30
7
2021
Statut:
ppublish
Résumé
To assess associations of hyperglycemia in pregnancy with the risk of postpartum hemorrhage (PPH) in a prospective cohort of Indigenous and non-Indigenous women, compared with normoglycemia. Data were from 1102 (48% Indigenous) women of the Pregnancy And Neonatal Diabetes Outcomes in Remote Australia (PANDORA) Study. Age-adjusted associations of gestational diabetes mellitus (GDM) or pre-existing type 2 diabetes mellitus (T2DM), obstetric and demographic covariables with PPH (blood loss ≥500 ml) were assessed using logistic regression. Multivariable-adjusted models included Indigenous ethnicity, diabetes type and their interaction. A higher proportion of Indigenous women developed PPH than non-Indigenous women (32% versus 22%; P < 0.001). Compared with non-Indigenous women with normoglycemia, risks of PPH for Indigenous women with GDM or T2DM were higher (odds ratio [OR] 1.83, 95% confidence intervals [CI] 1.11-3.02, and OR 1.72, 95% CI 0.99-3.00 after age adjustment, OR 1.84, 95% CI 1.06-3.19, and OR 1.33, 95% CI 0.70-2.54 after adjustment for school education and delivery mode, and OR 1.62, 95% CI 0.95-2.77, and OR 0.99, 95% CI 0.53-1.86 after adjustment for birth weight). Importantly, Indigenous women without hyperglycemia in pregnancy were not at increased risk of PPH. The significantly higher rates of PPH experienced by Indigenous women compared with non-Indigenous women may be explained by a greater effect of GDM among Indigenous women that was only partly accounted for by birth weight.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
296-304Subventions
Organisme : National Health and Medical Research Council of Australia
ID : 1032116
Organisme : National Health and Medical Research Council of Australia
ID : 1078333
Organisme : National Health and Medical Research Council of Australia
ID : 1137563
Organisme : National Health and Medical Research Council of Australia
ID : 1173952
Organisme : National Health and Medical Research Council of Australia
ID : 1078477
Organisme : National Health and Medical Research Council of Australia
ID : 1194698
Organisme : National Heart Foundation
ID : 101291
Organisme : Australian Postgraduate Award
Organisme : Sylvia and Charles Viertel Senior Medical Research Fellowship
Informations de copyright
© 2021 International Federation of Gynecology and Obstetrics.
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