Poster Presentation Australasian Diabetes in Pregnancy Society Annual Scientific Meeting 2019

Retrospective Audit of Obstetric Data: Prevalence and impact of obesity in early pregnancy in rural NW Tasmania (#55)

Sharon Luccisano 1 , Heinrich Webber 1 , Samistha Choudheri 1 , Iian Robertson 2 , Andrew Hills 2 , Giuliana Murfet 1
  1. Tasmanian Health Service, Burnie, TAS, Australia
  2. University of Tasmania, Launceston, TAS

 

Background

Maternal obesity is a significant health problem in Australia with potential adverse outcomes for both the mother and their offspring. Excess gestational weight gain (GWG) is associated with increased risk of gestational diabetes mellitus (GDM) and future development of type 2 diabetes for both mother and child.  Northwest Tasmania has a higher proportion of greater Socio-Economic Indexes for Areas (SEIFA) of disadvantage (i.e. the poorer areas) and poorer retention of health professionals.

Study Aims

To determine the prevalence of pregnant women in rural-regional NW Tasmania with a BMI >30 kg/m2 and associated maternal and neonatal adverse outcomes. 

Method

An expert advisory group informed data points for collection. An audit of antenatal and postnatal data was collected retrospectively from the Obstetrix digital medical record, of all women who gave birth between 2016-2018, residing in rural-regional northwest Tasmania.

Results

The audit (n-2132) identified 54.6% of women with overweight or obesity before pregnancy and 28% with a BMI >30 kg/m2. The proportion 10% higher than the State average and prominent in women living in areas of greater SEIFA disadvantage. The relationship between increasing BMI, smoking and lack of glucose tolerance testing was associated with maternal and neonatal adverse outcomes (data to be published, Luccisano). Notably, 35% (n=747) of pregnant women did not have a GTT performed and 39% were the lower BMI range (BMI <25 kg/m2). The absence of GDM screening was associated with a substantial increase in adverse neonatal outcomes including premature births and stillbirth. Further, 41.9% of pregnant women exhibited anxiety or depression.

Conclusions: Women with overweight or obesity during pregnancy are of high prevalence in northwest Tasmania, 10% higher than the statewide average. Reduced rates of screening for GDM via GTT require urgent attention due to the significant health impact on mother and baby. The association between GDM risk and BMI is exponential and increasing BMI is more prevalent in those women living in areas of greater SEIFA disadvantage. 

 

 

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