Abstract
BackgroundDiabetes in pregnancy carries an increased risk of adverse pregnancy outcomes for both the mother and foetus, but it also provides an excellent early opportunity for intervention in the life course for both mother and baby. In the context of the escalating epidemic of chronic diseases among Indigenous Australians, it is vital that this risk is reduced as early as possible in the life course of the individual. The aims of the PANDORA Study are to: (i) accurately assess rates of diabetes in pregnancy in the Northern Territory (NT) of Australia, where 38% of babies are born to Indigenous mothers; (ii) assess demographic, clinical, biochemical, anthropometric, socioeconomic and early life development factors that may contribute to key maternal and neonatal birth outcomes associated with diabetes in pregnancy; and (iii) monitor relevant post-partum clinical outcomes for both the mothers and their babies.Methods/DesignEligible participants are all NT women with diabetes in pregnancy aged 16 years and over. Information collected includes: standard antenatal clinical information, diagnosis and management of diabetes in pregnancy, socio-economic status, standard clinical birth information (delivery, gestational age, birth weight, adverse antenatal and birth outcomes). Cord blood is collected at the time of delivery and detailed neonatal anthropometric measurements performed within 72 hours of birth. Information will also be collected regarding maternal post-partum glucose tolerance and cardio-metabolic risk factor status, breastfeeding and growth of the baby up to 2 years post-partum in the first instance.DiscussionThis study will accurately document rates and outcomes of diabetes in pregnancy in the NT of Australia, including the high-risk Indigenous Australian population. The results of this study should contribute to policy and clinical guidelines with the goal of reducing the future risk of obesity and diabetes in both mothers and their offspring.
Highlights
Diabetes in pregnancy carries an increased risk of adverse pregnancy outcomes for both the mother and foetus, but it provides an excellent early opportunity for intervention in the life course for both mother and baby
We have developed a partnership between researchers, health care providers and policy organisations in the Northern Territory (NT), Australia, to address the issue of Diabetes in pregnancy (DIP) in the high-risk population of the NT
This study should provide answers to three key questions: (i) rates of diabetes in pregnancy in the NT, including the high risk Indigenous Australian population of remote and urban NT; (ii) demographic, clinical, biochemical, anthropometric and socioeconomic factors that may contribute to key maternal and neonatal outcomes associated with diabetes in pregnancy; and (iii) relevant clinical outcomes for mothers with DIP and their babies
Summary
The aims of the NT Diabetes in Pregnancy Partnership are to improve clinical care and outcomes of DIP in the NT, and to improve future health outcomes for both the mother and her baby through an integrated, multifaceted approach This includes a detailed research component, outlined above: the PANDORA Study. This study should provide answers to three key questions: (i) rates of diabetes in pregnancy in the NT, including the high risk Indigenous Australian population of remote and urban NT; (ii) demographic, clinical, biochemical, anthropometric and socioeconomic factors that may contribute to key maternal and neonatal outcomes associated with diabetes in pregnancy; and (iii) relevant clinical outcomes for mothers with DIP and their babies. All authors were involved in revising the manuscript for important intellectual content and read and approved the final manuscript
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