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Type: Journal article
Title: Primary health care for Aboriginal Australian women in remote communities after a pregnancy with hyperglycaemia
Author: Wood, A.
MacKay, D.
Fitzsimmons, D.
Derkenne, R.
Kirkham, R.
Boyle, J.A.
Connors, C.
Whitbread, C.
Welsh, A.
Brown, A.
Shaw, J.E.
Maple-Brown, L.
Citation: International Journal of Environmental Research and Public Health, 2020; 17(3):720-1-720-12
Publisher: MDPI AG
Issue Date: 2020
ISSN: 1660-4601
1660-4601
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Responsibility: 
Anna Wood, Diana MacKay, Dana Fitzsimmons, Ruth Derkenne, Renae Kirkham, Jacqueline A. Boyle, Christine Connors, Cherie Whitbread, Alison Welsh, Alex Brown, Jonathan E. Shaw, and Louise Maple-Brown
Abstract: Background: 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.
Keywords: Type 2 diabetes; gestational diabetes; indigenous health; primary health care; remote health care
Rights: © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
RMID: 1000012838
DOI: 10.3390/ijerph17030720
Grant ID: http://purl.org/au-research/grants/nhmrc/1092968
http://purl.org/au-research/grants/nhmrc/1151049
http://purl.org/au-research/grants/nhmrc/1078477
http://purl.org/au-research/grants/nhmrc/1079438
Appears in Collections:Medicine publications

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