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Diabetes Res Clin Pract. 2020 Mar;161:108028. doi: 10.1016/j.diabres.2020.108028. Epub 2020 Jan 19.

Social and economic factors, maternal behaviours in pregnancy and neonatal adiposity in the PANDORA cohort.

Author information

1
Menzies School of Health Research, Charles Darwin University, NT, Australia; Division of Medicine, Royal Children's Hospital, Victoria, Australia; Department of Paediatrics, Western Health, Victoria, Australia.
2
Menzies School of Health Research, Charles Darwin University, NT, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia.
3
Menzies School of Health Research, Charles Darwin University, NT, Australia.
4
Primary Health Care Branch, Top End Health Service, NT, Australia.
5
Menzies School of Health Research, Charles Darwin University, NT, Australia; Monash Centre for Health Research and Implementation, School of Preventative Medicine, Monash University, Melbourne, Australia.
6
University of South Australia, Adelaide, Australia.
7
Monash University, Melbourne, Australia.
8
Melbourne School of Population and Global Health, University of Melbourne, Australia.
9
Tufts University School of Medicine, Boston, MA, USA.
10
Mater Medical Research Institute, University of Queensland, Brisbane, Australia.
11
South Australian Health and Medical Research Institute, Adelaide, Australia; Faculty of Health and Medical Science, University of Adelaide, Australia.
12
Baker Heart and Diabetes Institute, Melbourne, Australia.
13
Menzies School of Health Research, Charles Darwin University, NT, Australia; Division of Medicine, Royal Darwin Hospital, NT, Australia. Electronic address: Louise.maple-brown@menzies.edu.au.

Abstract

BACKGROUND:

Australian Indigenous women experience high rates of social disadvantage and type 2 diabetes (T2D) in pregnancy, but it is not known how social factors and maternal behaviours impact neonatal adiposity in offspring of women with hyperglycaemia in pregnancy.

METHODS:

Participants were Indigenous (n = 404) and Europid (n = 240) women with gestational diabetes mellitus (GDM) or T2D in pregnancy and their offspring in the Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study. Social, economic factors, and maternal behaviours were measured in pregnancy and six neonatal anthropometric outcomes were examined after birth.

RESULTS:

On univariate analysis, maternal education < 12 years (p = 0.03), unemployment (p = 0.001), welfare income vs no welfare income (p = 0.001), lower area based socio-economic score (p < 0.001), and fast food intake > 2 times/week (p = 0.002) were associated with increased sum of skinfolds (SSF) in offspring. Smoking was significantly associated with a reduction in anthropometric measures, except SSF. In multivariable models adjusted for ethnicity, BMI and hyperglycaemia, social and economic factors were no longer significant predictors of neonatal outcomes. Smoking was independently associated with a reduction in length, head circumference and fat free mass. Frequent fast food intake remained independently associated with SSF (β-coefficient 1.08 mm, p = 0.02).

CONCLUSION:

In women with hyperglycaemia in pregnancy, social factors were associated with neonatal adiposity, particularly skinfold measures. Promoting smoking cessation and limited intake of energy-dense, nutrient-poor foods in pregnancy are important to improve neonatal adiposity and lean mass outcomes. Addressing inequities in social and economic factors are likely to be important, particularly for Indigenous women or women experiencing social disadvantage.

KEYWORDS:

Diabetes; Hyperglycaemia in pregnancy; Indigenous; Neonatal adiposity; Socio-economic

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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