Dataset Information

Maternal and neonatal outcomes in pregnancies with type 2 diabetes in First Nation and other Manitoban people: a population-based study.

ABSTRACT:

Background

First Nation people living in Canada experience a high prevalence of type 2 diabetes in pregnancy. In this study, we aimed to describe maternal and neonatal outcomes in First Nation and all other females with type 2 diabetes living in Manitoba, Canada.

Methods

This was a population-level retrospective cohort study using linked administrative data from Manitoba (2012-2017). We compared First Nation females with type 2 diabetes with all other Manitoban females with type 2 diabetes, using relative risks (RRs) and 95% confidence intervals (CIs).

Results

A total of 2181 females with type 2 diabetes were included, and 1218 (55.8%) were First Nation. First Nation females with type 2 diabetes were significantly more likely to experience stillbirth (RR 2.14, 95% CI 1.11-4.13) and perinatal death (RR 2.39, 95% CI 1.37-4.17) than all other Manitoban females with type 2 diabetes. Offspring of First Nation females with type 2 diabetes had a higher risk of most neonatal complications than offspring of all other Manitoban females with type 2 diabetes, including a higher risk of congenital malformations (RR 1.97, 95% CI 1.30-2.99), but First Nation people did not have a higher risk of most maternal complications.

Interpretation

First Nation pregnant individuals living with type 2 diabetes experienced a higher risk for adverse pregnancy outcomes than all other Manitoban females with type 2 diabetes. Additional studies are needed to identify both high-risk and protective factors for pregnancy complications in First Nation people living with type 2 diabetes in pregnancy.

SUBMITTER: Yamamoto JM

PROVIDER: S-EPMC9640167 | biostudies-literature | 2022 Oct-Dec

REPOSITORIES: biostudies-literature

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Publications

Maternal and neonatal outcomes in pregnancies with type 2 diabetes in First Nation and other Manitoban people: a population-based study.

Yamamoto Jennifer M JM Pylypjuk Christy C Sellers Elizabeth E McLeod Lorraine L Wicklow Brandy B Sirski Monica M Prior Heather H Ruth Chelsea C

CMAJ open 20221023 4

<h4>Background</h4>First Nation people living in Canada experience a high prevalence of type 2 diabetes in pregnancy. In this study, we aimed to describe maternal and neonatal outcomes in First Nation and all other females with type 2 diabetes living in Manitoba, Canada.<h4>Methods</h4>This was a population-level retrospective cohort study using linked administrative data from Manitoba (2012-2017). We compared First Nation females with type 2 diabetes with all other Manitoban females with type 2 ...[more]

PMID: 36280248

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Project description:ObjectiveTo examine the current literature surrounding the administration of antenatal corticosteroids in pregnancies complicated by diabetes and summarize the reported neonatal and maternal outcomes in exposed and unexposed groups.Data sourcesA systematic search was performed in November 2023 using Ovid Medline and Embase databases to identify relevant studies.Study eligibility criteriaArticles that reported on the maternal or neonatal outcomes in pregnancies complicated by pre-gestational or gestational diabetes after exposure to antenatal corticosteroids were included in this review. Articles were excluded if they did not separately report on the outcomes experienced by women with diabetes.MethodsMaternal and neonatal outcomes of interest included neonatal respiratory distress syndrome, neonatal hypoglycemia, and maternal hyperglycemia. Key words in this search included combinations of the terms related to pre-gestational and gestational diabetes, antenatal corticosteroids, respiratory distress syndrome, hypoglycemia, and hyperglycemia. Title and abstract screening was conducted in duplicate.ResultsThere were 19 studies that met the inclusion criteria. There were 13 studies that presented results pertaining to neonatal respiratory distress syndrome, 14 studies discussed neonatal hypoglycemia and 5 studies discussed maternal hyperglycemia. Only 2 included studies were randomized controlled trials with the remaining 17 studies being observational. There was heterogeneity in clinical settings, study populations, type of corticosteroid administered and timing of administration across the included studies. This review found that there is no clear evidence of beneficial effect of corticosteroid administration on neonatal respiratory outcomes in pregnancies complicated by diabetes. Additionally, there was discrepancy between studies reporting on neonatal hypoglycemia with 6 studies reporting an increased incidence in this outcome after antenatal corticosteroid exposure whilst 4 studies found no difference between exposed and unexposed groups. This review identified a specific gap in the reporting of maternal hyperglycemia following antenatal corticosteroids. The limited number of studies that did report this outcome unanimously reported an increased incidence of maternal hyperglycemia after corticosteroid exposure. The majority of studies had small sample sizes of pregnancies both complicated by diabetes and exposed to corticosteroids and therefore lacked sufficient power to make robust conclusions about the influence of antenatal corticosteroids in this group.ConclusionThis review concludes that there are insufficient data regarding the risks and benefits of antenatal corticosteroid administration in pregnancies complicated by diabetes.

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Dataset Information

Maternal and neonatal outcomes in pregnancies with type 2 diabetes in First Nation and other Manitoban people: a population-based study.

Background

Methods

Results

Interpretation

Publications

Maternal and neonatal outcomes in pregnancies with type 2 diabetes in First Nation and other Manitoban people: a population-based study.

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