Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017

Intergenerational effects of hyperglycaemia in pregnancy the PANDORA Wave 1 study     (#184)

Angela Titmuss 1 , Federica Barzi 1 , Alex Brown 2 , Christine Connors 3 , Jacqueline Boyle 4 , Liz Moore 5 , Elizabeth Death 1 , Danielle Longmore 1 , Kerin O'Dea 6 , Jeremy Oats 7 , David McIntyre 8 , Paul Zimmet 4 , Jonathan Shaw 9 , Louise Maple-Brown 1
  1. Menzies School of Health Research, Darwin, NT, Australia
  2. South Australian Health and Medical Research Institute, Adelaide, SA
  3. NT Department of Health, Darwin, NT
  4. Monash University, Melbourne, Vic
  5. Aboriginal Medical Services Alliance, NT, Darwin, NT
  6. University of South Australia, Adelaide, SA
  7. Melbourne School of Population and Global Health, Melbourne, Vic
  8. Mater Medical Research Institute, Brisbane, Qld
  9. Baker IDI Heart and Diabetes Institute, Melbourne, Vic

The risk of Type 2 diabetes (T2DM) is 20 times higher among Indigenous than non-Indigenous Australian children aged <17 years, with increased complication risk. The PANDORA study is a longitudinal birth cohort (n=1225) recruited from a hyperglycaemia in pregnancy (HIP) register across the Northern Territory, where 38% of children are born to Indigenous mothers, and the prevalence of T2DM in pregnancy is up to 10 times higher than in non-Indigenous mothers.

PANDORA Wave 1 is a sub-study (n=163) of Aboriginal (n=84) and Europid (n=79) mothers with HIP and their children aged 18 to 48 months, focusing on anthropometry and body composition measures. Data were analysed using t-tests, chi-squared tests; multivariable linear regression.

Children of Aboriginal and Europid mothers were similar in age at follow up [Aboriginal vs Europid, 33.5 vs 33.6 months, p=0.94], gender (56% vs 47% male, p=0.24) and birth weight z-score for gestation [0.33 (-0.62,1.42) vs 0.15 (-0.44,0.62), p=0.12]. However, Aboriginal children had lower current weight z-score (WHO) than Europid infants [-0.38 (-1.06,0.19) vs 0.31 (-0.22, 1.17), p<0.001]. Aboriginal and Europid mothers were similar in age (30.3 vs 32 years, p=0.056) and BMI (28.7 vs 27.7 kg/m2, p=0.35), but Aboriginal mothers were more likely to have T2DM in pregnancy (30% T2DM, 70% GDM vs 1% T2DM, 99% GDM, p<0.001).

On regression analysis, Indigenous ethnicity was negatively associated with child weight z-score [-1.1 (-1.59, -0.63), p<0.001], while maternal BMI [0.04 (0.002, 0.07), p<0.037] and birth weight z-score [0.21 (0.08, 0.4), p=0.04)] were positively associated.

These data suggesting poorer childhood growth of Aboriginal children may reflect ongoing challenges in Aboriginal health, including socioeconomic disadvantage, food insecurity, infection and malnutrition. Further work will assess adiposity, growth trajectories and other potential contributory factors to early onset T2DM in this population, with prevention or delay of T2DM vital to improve intergenerational outcomes.