Published online Jun 25, 2015. doi: 10.4239/wjd.v6.i6.880
Peer-review started: November 28, 2014
First decision: January 20, 2015
Revised: March 17, 2015
Accepted: April 27, 2015
Article in press: April 29, 2015
Published online: June 25, 2015
Processing time: 205 Days and 20.2 Hours
AIM: To perform a systematic review of reported neonatal and pregnancy outcomes of Indigenous Australians with diabetes in pregnancy (DIP).
METHODS: Electronic searches of PubMed and Web of Science were carried out. Articles were selected if they contained original data on DIP outcomes in Indigenous Australians. There were no specific exclusion criteria.
RESULTS: A total of eight articles, predominantly from Queensland and Western Australia were identified once inclusion criteria were applied. Birth data from midwifery registries or paper charts encompassing years 1985-2008 were used. A total of 465591 pregnant women with and without DIP were included in the eight studies, with 1363 being Indigenous women with DIP. Indigenous Australians experienced increased rates of many known adverse outcomes of DIP including: macrosomia, caesarean section, congenital deformities, low birth weight, hypoglycaemia, and neonatal trauma. There were regional differences among Indigenous Australians, particularly regional/remote vs metropolitan populations where the regional/remote data showed worse outcomes. Two of the articles did not note a difference between Aboriginals and Caucasians in the rates of measured adverse outcome. Studies varied significantly in size, measured outcomes, and subsequent analysis.
CONCLUSION: The health disparities between Indigenous Australians and non-Indigenous Australians are further evidenced by poorer outcomes in DIP. This has broader implications for Indigenous health in general.
Core tip: A review of all published data in Australia concerning diabetes in pregnancy outcomes in Indigenous Australians was performed. Of the eight articles identified, Indigenous Australians were shown to have higher rates of adverse outcomes compared to the non-Indigenous population. Living in a remote region appeared to increase the risk of an adverse outcome. This article highlights further health disparities between Indigenous and non-Indigenous, but also exposes gaps in regional data.