Dr David Soong Zheng Ng1, Dr Katherine Griffin2
1Logan Endocrine and Diabetes Services, Logan Hospital, Meadowbrook, Australia, 2Department of Endocrinology, Gold Coast University Hospital, Southport, Australia
Biography:
(David) Soong Zheng Ng is an endocrinologist and obstetric physician who is involved in the development of antenatal endocrinology and obstetric medicine services at Logan Hospital. His special interests include diabetes in pregnancy and the provision of antenatal care to a culturally and linguistically diverse population.
Abstract:
Pre-gestational diabetes, primarily type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), is associated with increased risk of adverse pregnancy outcomes. (1) These include maternal hypertension, pre-eclampsia, congenital malformations, neonatal macrosomia, premature delivery, operative delivery, caesarean section, stillbirth, and perinatal mortality. (1,2,3) Provision of high-quality care for women with pre-gestational diabetes is associated with reduced incidence of adverse pregnancy outcomes, however, despite significant advances in diabetes technology and obstetric care over the last 20 years, rates of adverse pregnancy outcomes for women with pre-gestational diabetes remain elevated. (2,3)
A retrospective audit was conducted to review maternal and neonatal outcomes for women with pre-gestational diabetes who delivered at Gold Coast University Hospital (GCUH) over a 5-year period (2017-2021). Data from the local electronic health record was collected and compared with a previous local audit, as well as published national and international outcomes. The rates of pre-eclampsia fell but remained above the national average. Pre-term delivery rates remained elevated but there were lower rates of neonatal morbidity, especially neonatal hypoglycaemia. The potential contributors to these differences were explored.
This audit and presentation aim to highlight changes in demographics and outcomes at GCUH and compare them with national and international outcomes. This will identify areas for improvement, help shape local service delivery, and contribute to the growing evidence base for improving maternity care for women with pre-gestational diabetes in Australia and internationally.
Keywords
Pre-gestational, diabetes, outcomes
References
1. Tennant PW, Glinianaia SV, Bilous RW, Rankin J, Bell R. Pre-existing diabetes, maternal glycated haemoglobin, and the risks of fetal and infant death: a population-based study. Diabetologia. 2014 Feb;57(2):285-94. doi: 10.1007/s00125-013-3108-5. Epub 2013 Nov 29. PMID: 24292565.
2. Mackin ST, Nelson SM, Kerssens JJ, Wood R, Wild S, Colhoun HM, Leese GP, Philip S, Lindsay RS; SDRN Epidemiology Group. Diabetes and pregnancy: national trends over a 15 year period. Diabetologia. 2018 May;61(5):1081-1088. doi: 10.1007/s00125-017-4529-3. Epub 2018 Jan 11. PMID: 29322220; PMCID: PMC6448996.
3. Murphy HR, Howgate C, O'Keefe J, Myers J, Morgan M, Coleman MA, Jolly M, Valabhji J, Scott EM, Knighton P, Young B, Lewis-Barned N; National Pregnancy in Diabetes (NPID) advisory group. Characteristics and outcomes of pregnant women with type 1 or type 2 diabetes: a 5-year national population-based cohort study. Lancet Diabetes Endocrinol. 2021 Mar;9(3):153-164. doi: 10.1016/S2213-8587(20)30406-X. Epub 2021 Jan 28. PMID: 33516295.