Adherence to screening guidelines for diabetes in pregnancy was poor in a review of clinical records in 807 women without known diabetes before pregnancy. Clinical records were obtained for women who had delivered in hospitals or community birth centres in the Waikato region during June–August 2017. Although 94% of women received some form of screening for diabetes in pregnancy, only 26.4% received screening as per the 2014 MOH guidelines. The most commonly performed screening was HbA1c testing, which was recorded in 83.9% of pregnancies. Screening rates by all measures were lower for Māori vs non-Māori with 17.5% of Māori receiving HbA1c testing and glucose load screening vs 31.6% of non-Māori (p<0.0005).
The numbers confirm what we’d already heard four years ago from wahine Māori living in Northland. This is unacceptable. Undiagnosed, and therefore under-managed, gestational diabetes is associated with poor birth outcomes, and long-term complications including diabetes and heart disease in māmā and their pēpi.
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.
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