The effect of obesity on pregnancy outcomes among Australian Indigenous and non-Indigenous women

Thrift, Aaron P. and Callaway, Leonie K. (2014) The effect of obesity on pregnancy outcomes among Australian Indigenous and non-Indigenous women. Medical Journal of Australia, 201 10: 592-595. doi:10.5694/mja13.11170

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Author Thrift, Aaron P.
Callaway, Leonie K.
Title The effect of obesity on pregnancy outcomes among Australian Indigenous and non-Indigenous women
Journal name Medical Journal of Australia   Check publisher's open access policy
ISSN 0025-729X
Publication date 2014-11
Year available 2014
Sub-type Article (original research)
DOI 10.5694/mja13.11170
Open Access Status
Volume 201
Issue 10
Start page 592
End page 595
Total pages 4
Place of publication Strawberry Hills, NSW Australia
Publisher Australasian Medical Publishing
Collection year 2015
Language eng
Formatted abstract
Objective: To assess whether the effect of pre-pregnancy overweight or obesity on maternal complications and perinatal outcomes is modified by Indigenous status.

Design, participants and setting: Population-based study using de-identified aggregate data on pregnancies resulting in singleton births from Indigenous (n = 13 582) and non-Indigenous (n = 241 270) women from the Queensland Perinatal Data Collection, 1 July 2007 to 31 December 2011.

Main outcome measures: Prevalence of maternal (gestational diabetes mellitus [GDM], hypertensive disorders of pregnancy [HDP]) and delivery (preterm birth, birthweight, Apgar score) outcomes by Indigenous status and their association with pre-pregnancy body mass index.

Results: In 57% of Indigenous pregnancies and 49% of non-Indigenous pregnancies, the mother was overweight, obese or severely obese. Prevalences of GDM, preterm birth and low birthweight were higher in Indigenous than non-Indigenous pregnancies. Overall rates of HDP were similar for Indigenous (5.1%) and non-Indigenous pregnancies (4.9%); however, rates were higher in normal-weight Indigenous pregnancies (4.0%) than in normal-weight non-Indigenous pregnancies (3.0%). We found that overweight or obesity was associated with higher prevalence of GDM, HDP, high birthweight and low Apgar score. However, the associations with HDP, preterm birth and low birthweight were modified by Indigenous status (P for interaction, < 0.001 for all). Overweight or obesity accounted for significantly fewer cases of HDP in Indigenous versus non-Indigenous pregnancies (population attributable fraction, 30% v 41%).

Maternal overweight or obesity is more common among Indigenous pregnancies, and Indigenous status may modify its association with pregnancy outcomes. Further research needs to explore the issue of increased insulin resistance and higher rates of HDP among normal-weight Indigenous women.
Keyword Body Mass Index (BMI)
Preterm Birth
Attributable Risk
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Public Health Publications
School of Medicine Publications
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