Voaklander, B.
Diabetes in Pregnancy Among Métis Women: A Retrospective Cohort Study
Voaklander B, Sanni O, Bradburn K, James A, Eurich D.T., Ospina M.B.
The Métis are an Indigenous group that evolved from First Nation and European unions into a distinct cultural and self-governing people. Métis people are underrepresented in health literature. The objective of this study is to assess the prevalence, maternal and perinatal outcomes of Métis women with diabetes in pregnancy compared to those of non-Métis women.
A retrospective cohort study of Métis and non-Métis singleton births between 2006 and 2016. Study outcomes include the prevalence of pre-existing diabetes (PEDM) and gestational diabetes mellitus (GDM) along with obstetric and perinatal outcomes. Bivariate analyses used t-tests for continuous variables, and chi2 test or fishers exact test for categorical variables. Prevalence estimates of GDM and PEDM were calculated and unadjusted logistic and linear regression models were used to compare outcomes in Métis women to non-Métis women.
A total of 483,300 singleton births were included in the study (7,977 Métis births, and 475,323 non-Métis births). GDM prevalence among Métis women was 4.86% compared to non-Métis women 5.32% (OR=0.90, 95%CI: 0.80, 1.0). Métis women had 22% increased odds of having PEDM compared to non-Métis women (OR=1.22 95%CI: 1.01, 1.47). Métis women with GDM were on average 21 months younger, (β=-1.77 95%CI: -2.29, -1.25), had babies on average 154 g heavier (β=154.44, 95%CI: 94.56, 214.33), have increased odds of having a baby with congenital anomalies (OR=2.31, 95%CI: 1.25, 4.29) and having babies large for gestational age (OR=1.79 95%CI: 1.41, 4.27). Métis women with PEDM were on average two years younger (β=-2.02, 95%CI: -3.03, -1.00) and have increased odds of having preeclampsia compared to non-Métis women (OR=3.07, 95%CI: 1.62, 5.81).
The results of this study highlight important differences in the outcomes of GDM and PEDM among Métis women compared to non-Métis women and can inform prenatal health services for Métis women with GDM or PEDM.