Primary Health Care for Aboriginal Australian Women in Remote Communities after a Pregnancy with Hyperglycaemia

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...

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Main Authors: Anna Wood, Diana MacKay, Dana Fitzsimmons, Ruth Derkenne, Renae Kirkham, Jacqueline A. Boyle, Christine Connors, Cherie Whitbread, Alison Welsh, Alex Brown, Jonathan E. Shaw, Louise Maple-Brown
Format: Article
Language:English
Published: MDPI AG 2020-01-01
Series:International Journal of Environmental Research and Public Health
Subjects:
Online Access:https://www.mdpi.com/1660-4601/17/3/720
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spelling doaj-f03b2c781d124811917f46a41e135b752020-11-25T02:18:02ZengMDPI AGInternational Journal of Environmental Research and Public Health1660-46012020-01-0117372010.3390/ijerph17030720ijerph17030720Primary Health Care for Aboriginal Australian Women in Remote Communities after a Pregnancy with HyperglycaemiaAnna Wood0Diana MacKay1Dana Fitzsimmons2Ruth Derkenne3Renae Kirkham4Jacqueline A. Boyle5Christine Connors6Cherie Whitbread7Alison Welsh8Alex Brown9Jonathan E. Shaw10Louise Maple-Brown11Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, AustraliaWellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, AustraliaNorthern Territory Department of Health, Darwin, NT 8000, AustraliaNorthern Territory Department of Health, Darwin, NT 8000, AustraliaWellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, AustraliaWellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, AustraliaNorthern Territory Department of Health, Darwin, NT 8000, AustraliaWellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, AustraliaNorthern Territory Department of Health, Darwin, NT 8000, AustraliaSouth Australia Health and Medical Research Institute, Adelaide, SA 5000, AustraliaAboriginal Health Domain, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, AustraliaWellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, AustraliaBackground: 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&#8722;2014 identified 195 women who experienced hyperglycaemia in pregnancy (gestational diabetes (GDM) (<i>n</i> = 147), type 2 diabetes (T2D) (<i>n</i> = 39), and unclear diabetes status (<i>n</i> = 9)). Results: Only 80 women (54%) with GDM had postpartum glycaemic checks. Of these, 32 women were diagnosed with prediabetes (<i>n</i> = 24) or diabetes (<i>n</i> = 8). Compared to women with GDM, women with T2D were more likely to have their weight measured (75% vs. 52%, <i>p</i> &lt;0.01), and smoking status documented as &#8220;discussed&#8221; (65% vs. 34%, <i>p</i> &lt; 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.https://www.mdpi.com/1660-4601/17/3/720type 2 diabetesgestational diabetesindigenous healthprimary health careremote health care
collection DOAJ
language English
format Article
sources DOAJ
author Anna Wood
Diana MacKay
Dana Fitzsimmons
Ruth Derkenne
Renae Kirkham
Jacqueline A. Boyle
Christine Connors
Cherie Whitbread
Alison Welsh
Alex Brown
Jonathan E. Shaw
Louise Maple-Brown
spellingShingle Anna Wood
Diana MacKay
Dana Fitzsimmons
Ruth Derkenne
Renae Kirkham
Jacqueline A. Boyle
Christine Connors
Cherie Whitbread
Alison Welsh
Alex Brown
Jonathan E. Shaw
Louise Maple-Brown
Primary Health Care for Aboriginal Australian Women in Remote Communities after a Pregnancy with Hyperglycaemia
International Journal of Environmental Research and Public Health
type 2 diabetes
gestational diabetes
indigenous health
primary health care
remote health care
author_facet Anna Wood
Diana MacKay
Dana Fitzsimmons
Ruth Derkenne
Renae Kirkham
Jacqueline A. Boyle
Christine Connors
Cherie Whitbread
Alison Welsh
Alex Brown
Jonathan E. Shaw
Louise Maple-Brown
author_sort Anna Wood
title Primary Health Care for Aboriginal Australian Women in Remote Communities after a Pregnancy with Hyperglycaemia
title_short Primary Health Care for Aboriginal Australian Women in Remote Communities after a Pregnancy with Hyperglycaemia
title_full Primary Health Care for Aboriginal Australian Women in Remote Communities after a Pregnancy with Hyperglycaemia
title_fullStr Primary Health Care for Aboriginal Australian Women in Remote Communities after a Pregnancy with Hyperglycaemia
title_full_unstemmed Primary Health Care for Aboriginal Australian Women in Remote Communities after a Pregnancy with Hyperglycaemia
title_sort primary health care for aboriginal australian women in remote communities after a pregnancy with hyperglycaemia
publisher MDPI AG
series International Journal of Environmental Research and Public Health
issn 1660-4601
publishDate 2020-01-01
description 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&#8722;2014 identified 195 women who experienced hyperglycaemia in pregnancy (gestational diabetes (GDM) (<i>n</i> = 147), type 2 diabetes (T2D) (<i>n</i> = 39), and unclear diabetes status (<i>n</i> = 9)). Results: Only 80 women (54%) with GDM had postpartum glycaemic checks. Of these, 32 women were diagnosed with prediabetes (<i>n</i> = 24) or diabetes (<i>n</i> = 8). Compared to women with GDM, women with T2D were more likely to have their weight measured (75% vs. 52%, <i>p</i> &lt;0.01), and smoking status documented as &#8220;discussed&#8221; (65% vs. 34%, <i>p</i> &lt; 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.
topic type 2 diabetes
gestational diabetes
indigenous health
primary health care
remote health care
url https://www.mdpi.com/1660-4601/17/3/720
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