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Screening for diabetes in pregnancy in a regional area with a high Māori population

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Authors:
Summary:

Outcomes are reported from an audit performed on routine hospital data collected from 656 women who gave birth over two 6-month periods (June to December in 2013 and 2014) in two Mid-North Island hospitals in the Bay of Plenty region, an area with a high Māori population. Just 416 (63%) women were screened for diabetes in pregnancy, including 390 (60%) for gestational diabetes mellitus (GDM) later in pregnancy. Significantly higher proportions of New Zealand European/Other and Asian women were screened compared with Māori women (75% and 77% vs 56%, respectively; p<0.0001). After controlling for ethnicity, women aged 35–40 years were more likely to be screened compared with those aged 25–29 years (77% vs 61%; p=0.02). Screening was associated with longer hospital stays following birth; screened women were more likely to stay >5 days than <1 day, compared with unscreened women (84% vs 56%; p<0.0001). A significantly higher proportion of women were screened in 2014 than in 2013 (68% vs 58%; p=0.008).

Comment:
Given the higher rates of GDM, and poor antenatal outcomes associated with it, amongst Māori women, I cannot believe that only 56% of Māori women were screened for it. A major positive to take from this study is that rates improved in one year, suggesting that the audit itself may have had a positive impact on clinical care.
Reference: N Z Med J. 2017;130(1450):25-31
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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