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

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
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Anna Wood: Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia
Diana MacKay: Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia
Dana Fitzsimmons: Northern Territory Department of Health, Darwin, NT 8000, Australia
Ruth Derkenne: Northern Territory Department of Health, Darwin, NT 8000, Australia
Renae Kirkham: Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia
Jacqueline A. Boyle: Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia
Christine Connors: Northern Territory Department of Health, Darwin, NT 8000, Australia
Cherie Whitbread: Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia
Alison Welsh: Northern Territory Department of Health, Darwin, NT 8000, Australia
Alex Brown: South Australia Health and Medical Research Institute, Adelaide, SA 5000, Australia
Jonathan E. Shaw: Aboriginal Health Domain, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
Louise Maple-Brown: Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia

IJERPH, 2020, vol. 17, issue 3, 1-12

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 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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