Gestational diabetes is associated with postpartum hemorrhage in Indigenous Australian women in the PANDORA study: a prospective cohort.

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dc.contributor.authorLucas, I.M.
dc.contributor.authorBarr, E.L.M.
dc.contributor.authorBarzi, F.
dc.contributor.authorLongmore, D.K.
dc.contributor.authorLee, I.-L.
dc.contributor.authorKirkwood, M.
dc.contributor.authorWhitbread, C.
dc.contributor.authorConnors, C.
dc.contributor.authorBoyle, J.A.
dc.contributor.authorSimon, D.
dc.contributor.authorGoodrem, A.
dc.contributor.authorBrown, A.D.H.
dc.contributor.authorOats, J.
dc.contributor.authorMcIntyre, H.D.
dc.contributor.authorShaw, J.E.
dc.contributor.authorMaple-Brown, L.
dc.contributor.authorPANDORA study research team,
dc.date.issued2021
dc.description.abstractObjective 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 to normoglycemia.<h4>Methods</h4>Data were from 1,102 (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 ≥500ml) were assessed using logistic regression. Multivariable-adjusted models included Indigenous ethnicity, diabetes type and their interaction.<h4>Results</h4>A higher proportion of Indigenous women developed PPH than non-Indigenous women (32% vs. 22%; p<0.001). Compared to non-Indigenous women with normoglycemia, risks of PPH for Indigenous women with GDM or T2DM were (OR=1.83 [95%CI: 1.11-3.02] and 1.72 [0.99-3.00] after age adjustment, 1.84 [1.06-3.19] and 1.33 [0.70-2.54] after adjustment for school education and delivery mode, and 1.62 [0.95-2.77] and 0.99 [0.53-1.86] after adjustment for birth weight). Importantly, Indigenous women without hyperglycemia in pregnancy were not at increased risk of PPH. Conclusion The significantly higher rates of PPH experienced by Indigenous compared to non-Indigenous women may be explained by a greater effect of GDM among Indigenous women that was only partly accounted for by birth weight.
dc.description.statementofresponsibilityIsabelle M. Lucas, Elizabeth L. M. Barr, Federica Barzi, Danielle K. Longmore, I-Lynn Lee, Marie Kirkwood ... et al.
dc.identifier.citationInternational Journal of Gynecology and Obstetrics, 2021; 155(2):1-9
dc.identifier.doi10.1002/ijgo.13846
dc.identifier.issn0020-7292
dc.identifier.issn1879-3479
dc.identifier.orcidBrown, A.D.H. [0000-0003-2112-3918]
dc.identifier.urihttps://hdl.handle.net/2440/132570
dc.language.isoen
dc.publisherWiley
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1078333
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1032116
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1173952
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1194698
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1078477
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1137563
dc.rights©2021 International Federation of Gynecology and Obstretics
dc.source.urihttps://doi.org/10.1002/ijgo.13846
dc.subjectantenatal care; hyperglycemia in pregnancy; Indigenous population; population health; postpartum hemorrhage
dc.titleGestational diabetes is associated with postpartum hemorrhage in Indigenous Australian women in the PANDORA study: a prospective cohort.
dc.typeJournal article
pubs.publication-statusPublished

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