Dr Helena Qian1,2,3, James Elhindi1, Lily Bouhadir4, Dr Olivia Byrnes5, Prof N Wah Cheung1,6, Michelle de Vroome7,8, Geraldine Gilroy9, A/Prof Tanya Nippita1,7,8, Michelle Simmons10, Gayatri Talla11, Lisa White12, Dipti Zachariah13, Prof Dharmintra Pasupathy1, Dr Sarah J Melov1,14
1Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia, 2Royal Hospital for Women, Randwick, Australia, 3University of New South Wales, Sydney, Australia, 4Auburn Hospital, Auburn, Australia, 5Nepean Hospital, Kingswood, Australia, 6Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, Australia, 7North Sydney Local Health District, Sydney, Australia, 8The University of Sydney, Faculty of Medicine and Health, Sydney, Australia, 9Central Coast Local Health District, Gosford, Australia, 10Women’s and Newborn Health, Westmead Hospital, Westmead , Australia, 11Consumer Representative, Western Sydney Local Health District, , Sydney, Australia, 12Women’s Health Maternity, Blacktown and Mount Druitt Hospitals, Blacktown, Australia, 13Multicultural Health, Statewide and Specialist Programs Priority Populations, Integrated and Community Health, Western Sydney Local Health District, Sydney, Australia, 14Westmead Institute for Maternal and Fetal Medicine, Women’s and Newborn Health, Westmead Hospital, Westmead, Australia
Biography:
Helena is an award winning junior doctor with interests in migrant health, clinical governance, and effective altruism. She has represented Australia at international forums including the UN High Level Meeting on Universal Health Coverage and WHO Regional Meetings. Helena also enjoys learning AUSLAN, globetrotting and honing her culinary skills.
Abstract:
Background: Literature identifies an association between length of residence (LOR) for migrants and increasing risk of poor health outcomes including obesity and metabolic syndrome. The association between migration and the risk of gestational diabetes (GDM) is unknown.
Aim: Investigate the relationship between LOR in Australia among different migrant populations and risk for GDM.
Methodology: Retrospective observational cohort study from June 2020 to November 2023 using routinely collected data from ten Australian hospitals in four local health districts. Exclusion criteria included births <20 weeks' gestation and multiple pregnancies. Ethnicity is self-identified by participants. Recent migrants were classified as ≤5 years LOR. Logistic regression models were adjusted for confounding factors including the GDM criteria used at each site over time.
Results: Data from 62,520 participants were available for analysis, 28,914 (46.2%) were migrants (n=9,150 recent). South Asian was the largest migrant population (n=11,695, 18.7%). Later migrants were more likely to be older (33.4 [SD 4.6] vs 31.1 [SD 4.5] years), multiparous (66.7% vs 44.7%) and obese (17.5% vs 11.8%). The median cohort migrant LOR in Australia was 7 years. GDM rates differed across health districts and overall was 17.9%. Compared to first arrival in Australia, the risk of GDM grew year on year before plateauing after approximately 5 years (at 5 years: OR 1.52 [1.17 – 2.01]; aOR 1.19 [0.97 – 1.51]). However, white migrants experienced no such effect (at 5 years: OR 0.98 [0.77 – 1.28]); aOR: 0.80 [0.67, 0.99]).
Discussion: This is the first study we are aware of that identifies the duration of migrants’ residency as increasing the risk for GDM, the reasons for this are unclear. New migrant women may benefit from lifestyle interventions to preserve a lower cardiometabolic risk. Further investigation is warranted to understand the complex interplay between migration, ethnicity, acculturation and GDM risk.
Keywords
migrant health, gestational diabetes, length of stay, level of acculturation