24 results on '"Kirkwood, Marie"'
Search Results
2. Corrigendum to “Type 2 diabetes after a pregnancy with gestational diabetes among first nations women in Australia: The PANDORA study” [Diabetes Res. Clin. Pract. 181 (2021) 109092]
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Wood, Anna J., primary, Boyle, Jacqueline A., additional, Barr, Elizabeth L.M., additional, Barzi, Federica, additional, Hare, Matthew J.L., additional, Titmuss, Angela, additional, Longmore, Danielle K., additional, Death, Elizabeth, additional, Kelaart, Joanna, additional, Kirkwood, Marie, additional, Graham, Sian, additional, Connors, Christine, additional, Moore, Elizabeth, additional, O'Dea, Kerin, additional, Oats, Jeremy J.N., additional, McIntyre, Harold D., additional, Zimmet, Paul Z., additional, Lu, Zhong X., additional, Brown, Alex, additional, Shaw, Jonathan E., additional, and Maple-Brown, Louise J., additional
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- 2024
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3. Type 2 diabetes after a pregnancy with gestational diabetes among first nations women in Australia: The PANDORA study
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Wood, Anna J., Boyle, Jacqueline A., Barr, Elizabeth L.M., Barzi, Federica, Hare, Matthew J.L., Titmuss, Angela, Longmore, Danielle K., Death, Elizabeth, Kelaart, Joanna, Kirkwood, Marie, Graham, Sian, Connors, Christine, Moore, Elizabeth, O'Dea, Kerin, Oats, Jeremy J.N., McIntyre, Harold D., Zimmet, Paul Z., Lu, Zhong X., Brown, Alex, Shaw, Jonathan E., and Maple-Brown, Louise J.
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- 2021
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4. Social and economic factors, maternal behaviours in pregnancy and neonatal adiposity in the PANDORA cohort
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Longmore, Danielle K., Barr, Elizabeth L.M., Barzi, Federica, Lee, I-Lynn, Kirkwood, Marie, Connors, Christine, Boyle, Jacqueline, O'Dea, Kerin, Zimmet, Paul, Oats, Jeremy, Catalano, Patrick, McIntyre, H. David, Brown, Alex D.H., Shaw, Jonathan E., and Maple-Brown, Louise J.
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- 2020
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5. Associations of gestational diabetes and type 2 diabetes during pregnancy with breastfeeding at hospital discharge and up to 6 months: the PANDORA study
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Longmore, Danielle K., Barr, Elizabeth L. M., Wilson, Alyce N., Barzi, Federica, Kirkwood, Marie, Simmonds, Alison, Lee, I-Lynn, Hawthorne, Eyvette, Van Dokkum, Paula, Connors, Christine, Boyle, Jacqueline A., Zimmet, Paul, O’Dea, Kerin, Oats, Jeremy, McIntyre, Harold D., Brown, Alex D. H., Shaw, Jonathan E., and Maple-Brown, Louise J.
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- 2020
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6. Repeat pneumococcal polysaccharide vaccine in Indigenous Australian adults is associated with decreased immune responsiveness
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Moberley, Sarah, Licciardi, Paul V., Balloch, Anne, Andrews, Ross, Leach, Amanda J., Kirkwood, Marie, Binks, Paula, Mulholland, Kim, Carapetis, Jonathan, Tang, Mimi L.K., and Skull, Sue
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- 2017
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7. AMERICAN COLLEGE CHAPELS
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Gray, Clifton D., Cowling, Donald J., Gage, Harry M., Gilkey, Charles W., Alton, Alfred E., Mierow, C. C., Knox, Raymond C., Lingle, Walter L., Shaw, Avery A., Harper, W. A., Apple, Henry H., Johnson, Wallace B., Dimnent, Edward D., Kroeze, B. H., Lewis, William M., Aronoff, Alice J., Rall, Edward Everett, Bohn, W. F., Greene, Clarence W., Wicks, Robert R., Mitchell, L. E., Silver, Earl Reed, Bell, Bernard I., Whaling,, H. M., Gardner, D. C., Blanshard, Frances, Ellery, Edward, Kinsolving, Arthur B., Crochett, Walter H., Henshaw,, F. R., Kirkwood, Marie, Wishart, Charles F., and Nash, G. W.
- Published
- 1930
8. Gestational diabetes is associated with postpartum hemorrhage in Indigenous Australian women in the PANDORA study: A prospective cohort.
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Lucas, Isabelle M., Barr, Elizabeth L. M., Barzi, Federica, Longmore, Danielle K., Lee, I‐Lynn, Kirkwood, Marie, Whitbread, Cherie, Connors, Christine, Boyle, Jacqueline A., Simon, David, Goodrem, Adeliesje, Brown, Alex D. H., Oats, Jeremy, McIntyre, Harold D., Shaw, Jonathan E., and Maple‐Brown, Louise
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- 2021
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9. Improving postpartum screening after diabetes in pregnancy: Results of a pilot study in remote Australia
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Kirkham, Renae, primary, MacKay, Diana, additional, Barzi, Federica, additional, Whitbread, Cherie, additional, Kirkwood, Marie, additional, Graham, Sian, additional, Van Dokkum, Paula, additional, McIntyre, H. David, additional, Shaw, Jonathan E., additional, Brown, Alex, additional, O'Dea, Kerin, additional, Connors, Christine, additional, Oats, Jeremy, additional, Zimmet, Paul, additional, Boyle, Jacqueline, additional, and Maple‐Brown, Louise, additional
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- 2018
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10. Cord blood metabolic markers are strong mediators of the effect of maternal adiposity on fetal growth in pregnancies across the glucose tolerance spectrum: the PANDORA study.
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Lee, I-Lynn, Barr, Elizabeth L. M., Longmore, Danielle, Barzi, Federica, Brown, Alex D. H., Connors, Christine, Boyle, Jacqueline A., Kirkwood, Marie, Hampton, Vanya, Lynch, Michael, Lu, Zhong X., O'Dea, Kerin, Oats, Jeremy, McIntyre, H. David, Zimmet, Paul, Shaw, Jonathan E., and Maple-Brown, Louise J.
- Abstract
Aims/hypothesis: We aimed to assess associations between cord blood metabolic markers and fetal overgrowth, and whether cord markers mediated the impact of maternal adiposity on neonatal anthropometric outcomes among children born to Indigenous and Non-Indigenous Australian women with normal glucose tolerance (NGT), gestational diabetes mellitus (GDM) and pregestational type 2 diabetes mellitus. Methods: From the Pregnancy and Neonatal Outcomes in Remote Australia (PANDORA) study, an observational cohort of 1135 mother–baby pairs, venous cord blood was available for 645 singleton babies (49% Indigenous Australian) of women with NGT (n = 129), GDM (n = 419) and type 2 diabetes (n = 97). Cord glucose, triacylglycerol, HDL-cholesterol, C-reactive protein (CRP) and C-peptide were measured. Multivariable logistic and linear regression were used to assess the associations between cord blood metabolic markers and the outcomes of birthweight z score, sum of skinfold thickness (SSF), being large for gestational age (LGA) and percentage of body fat. Pathway analysis assessed whether cord markers mediated the associations between maternal and neonatal adiposity. Results: Elevated cord C-peptide was significantly associated with increasing birthweight z score (β 0.57 [95% CI 0.42, 0.71]), SSF (β 0.83 [95% CI 0.41, 1.25]), percentage of body fat (β 1.20 [95% CI 0.69, 1.71]) and risk for LGA [OR 3.14 [95% CI 2.11, 4.68]), after adjusting for age, ethnicity and diabetes type. Cord triacylglycerol was negatively associated with birthweight z score for Indigenous Australian women only. No associations between cord glucose, HDL-cholesterol and CRP >0.3 mg/l (2.9 nmol/l) with neonatal outcomes were observed. C-peptide mediated 18% (95% CI 13, 36) of the association of maternal BMI with LGA and 11% (95% CI 8, 17) of the association with per cent neonatal fat. Conclusions/interpretation: Cord blood C-peptide is an important mediator of the association between maternal and infant adiposity, across the spectrum of maternal glucose tolerance. [ABSTRACT FROM AUTHOR]
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- 2020
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11. Real‐world experience of metformin use in pregnancy: Observational data from the Northern Territory Diabetes in Pregnancy Clinical Register.
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Maple‐Brown, Louise J., Lindenmayer, Greta, Barzi, Federica, Whitbread, Cherie, Connors, Christine, Moore, Elizabeth, Boyle, Jacqueline, Kirkwood, Marie, Lee, I‐Lynn, Longmore, Danielle, van Dokkum, Paula, Wicks, Mary, Dowden, Michelle, Inglis, Chrissie, Cotter, Margaret, Kirkham, Renae, Corpus, Sumaria, Chitturi, Sridhar, Thomas, Sujatha, and O'Dea, Kerin
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DIABETES in women ,GESTATIONAL diabetes ,PREGNANCY ,DIET therapy ,TYPE 2 diabetes ,MATERNAL age - Abstract
Copyright of Journal of Diabetes is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2019
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12. Improving postpartum screening after diabetes in pregnancy: Results of a pilot study in remote Australia.
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Kirkham, Renae, MacKay, Diana, Barzi, Federica, Whitbread, Cherie, Kirkwood, Marie, Graham, Sian, Van Dokkum, Paula, McIntyre, H. David, Shaw, Jonathan E., Brown, Alex, O'Dea, Kerin, Connors, Christine, Oats, Jeremy, Zimmet, Paul, Boyle, Jacqueline, and Maple‐Brown, Louise
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BLOOD sugar ,GESTATIONAL diabetes ,ETHNOPSYCHOLOGY ,GLUCOSE tolerance tests ,GLYCOSYLATED hemoglobin ,MEDICAL screening ,ONLINE information services ,PREGNANCY complications ,PUERPERIUM ,RESEARCH funding ,WOMEN'S health ,TEXT messages ,PILOT projects ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Background: The postpartum period is a critical time to improve health outcomes for Aboriginal women, particularly for those who have chronic conditions. Aims: To assess enhanced support methods (for women following diabetes in pregnancy (DIP)) to improve completion rates of recommended postpartum health checks. Materials and Methods: Fifty‐three Aboriginal women in the Northern Territory (NT) were contacted in the postpartum period to encourage medical check‐ups. Messages were delivered through phone (call or text messages) or other methods (Facebook or email). The primary outcome was postpartum blood glucose testing (oral glucose tolerance testing (OGTT), random or fasting glucose and HbA1c). Results: Establishing contact with women was difficult. Of 137 messages sent to 52 women, 22 responded (42%). Phone was the most common contact method with successful contact made from 16 of 119 (13%) attempts. Rates of postpartum OGTT completion were higher in the group successfully contacted (32% vs 7%). However, for any postpartum glucose testing (including OGTT and HbA1c) rates were 25 of 42 (60%) and neither success in making contact nor the contact method was associated with higher rates. Conclusions: The small sample size limits our conclusions; however, results highlight that engaging remote women postpartum is difficult. While rates of postpartum OGTT completion differed according to successful contacts, rates of any postpartum blood glucose testing did not. Further research is needed to explore feasible intervention methods to improve postpartum screening after a pregnancy complicated by diabetes. [ABSTRACT FROM AUTHOR]
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- 2019
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13. Pregnancy And Neonatal Diabetes Outcomes in Remote Australia: the PANDORA study-an observational birth cohort.
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Maple-Brown, Louise, Lee, I-Lynn, Longmore, Danielle, Barzi, Federica, Connors, Christine, Boyle, Jacqueline A, Moore, Elizabeth, Whitbread, Cherie, Kirkwood, Marie, Graham, Sian, Hampton, Vanya, Simmonds, Alison, Dokkum, Paula Van, Kelaart, Joanna, Thomas, Sujatha, Chitturi, Shridhar, Eades, Sandra, Corpus, Sumaria, Lynch, Michael, and Lu, Zhong X
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GESTATIONAL diabetes ,HYPERGLYCEMIA ,PREGNANCY complications ,BODY mass index ,TYPE 2 diabetes - Abstract
Background: In Australia's Northern Territory, 33% of babies are born to Indigenous mothers, who experience high rates of hyperglycemia in pregnancy. We aimed to determine the extent to which pregnancy outcomes for Indigenous Australian women are explained by relative frequencies of diabetes type [type 2 diabetes (T2DM) and gestational diabetes (GDM)].Methods: This prospective birth cohort study examined participants recruited from a hyperglycemia in pregnancy register. Baseline data collected were antenatal and perinatal clinical information, cord blood and neonatal anthropometry. Of 1135 women (48% Indigenous), 900 had diabetes: 175 T2DM, 86 newly diagnosed diabetes in pregnancy (DIP) and 639 had GDM. A group of 235 women without hyperglycemia in pregnancy was also recruited.Results: Diabetes type differed for Indigenous and non-Indigenous women (T2DM, 36 vs 5%; DIP, 15 vs 7%; GDM, 49 vs 88%, p < 0.001). Within each diabetes type, Indigenous women were younger and had higher smoking rates. Among women with GDM/DIP, Indigenous women demonstrated poorer birth outcomes than non-Indigenous women: large for gestational age, 19 vs 11%, p = 0·002; neonatal fat 11.3 vs 10.2%, p < 0.001. In the full cohort, on multivariate regression, T2DM and DIP were independently associated (and Indigenous ethnicity was not) with pregnancy outcomes.Conclusions: Higher rates of T2DM among Indigenous women predominantly contribute to absolute poorer pregnancy outcomes among Indigenous women with hyperglycemia. As with Indigenous and minority populations globally, prevention or delay of type 2 diabetes in younger women is vital to improve pregnancy outcomes and possibly to improve the long-term health of their offspring. [ABSTRACT FROM AUTHOR]- Published
- 2019
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14. Anthropometrics of neonates born to mothers with diabetes in pregnancy in the Northern Territory
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Longmore, Danielle, primary, Brown, Alex, additional, Lee, I-Lynn, additional, Connors, Christine, additional, Whitbread, Cherie, additional, Kirkwood, Marie, additional, Oats, Jeremy, additional, McIntyre, David, additional, Shaw, Jonathan, additional, Zimmet, Paul, additional, O’Dea, Kerin, additional, and Maple-Brown, Louise, additional
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- 2015
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15. Implementation of a diabetes in pregnancy clinical register in a complex setting: Findings from a process evaluation.
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Kirkham, Renae, Whitbread, Cherie, Connors, Christine, Moore, Elizabeth, Boyle, Jacqueline A., Richa, Richa, Barzi, Federica, Li, Shu, Dowden, Michelle, Oats, Jeremy, Inglis, Chrissie, Cotter, Margaret, McIntyre, Harold D., Kirkwood, Marie, Van Dokkum, Paula, Svenson, Stacey, Zimmet, Paul, Shaw, Jonathan E., O’Dea, Kerin, and Brown, Alex
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GESTATIONAL diabetes ,ABORIGINAL Australians ,MEDICAL care ,FOCUS groups ,COORDINATION (Human services) ,MEDICAL registries - Abstract
Background: Rates of diabetes in pregnancy are disproportionately higher among Aboriginal than non-Aboriginal women in Australia. Additional challenges are posed by the context of Aboriginal health including remoteness and disadvantage. A clinical register was established in 2011 to improve care coordination, and as an epidemiological and quality assurance tool. This paper presents results from a process evaluation identifying what worked well, persisting challenges and opportunities for improvement. Methods: Clinical register data were compared to the Northern Territory Midwives Data Collection. A cross-sectional survey of 113 health professionals across the region was also conducted in 2016 to assess use and value of the register; and five focus groups (49 healthcare professionals) documented improvements to models of care. Results: From January 2012 to December 2015, 1,410 women were referred to the register, 48% of whom were Aboriginal. In 2014, women on the register represented 75% of those on the Midwives Data Collection for Aboriginal women with gestational diabetes and 100% for Aboriginal women with pre-existing diabetes. Since commencement of the register, an 80% increase in reported prevalence of gestational diabetes among Aboriginal women in the Midwives Data Collection occurred (2011–2013), prior to adoption of new diagnostic criteria (2014). As most women met both diagnostic criteria (81% in 2012 and 74% in 2015) it is unlikely that the changes in criteria contributed to this increase. Over half (57%) of survey respondents reported improvement in knowledge of the epidemiology of diabetes in pregnancy since establishment of the register. However, only 32% of survey respondents thought that the register improved care-coordination. The need for improved integration and awareness to increase use was also highlighted. Conclusion: Although the register has not been reported to improve care coordination, it has contributed to increased reported prevalence of gestational diabetes among high risk Aboriginal women, in a routinely collected jurisdiction-wide pregnancy dataset. It has therefore contributed to an improved understanding of epidemiology and disease burden and may in future contribute to improved management and outcomes. Regions with similar challenges in context and high risk populations for diabetes in pregnancy may benefit from this experience of implementing a register. [ABSTRACT FROM AUTHOR]
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- 2017
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16. Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study
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Maple-Brown, Louise J, primary, Brown, Alex, additional, Lee, I-Lynn, additional, Connors, Christine, additional, Oats, Jeremy, additional, McIntyre, Harold D, additional, Whitbread, Cherie, additional, Moore, Elizabeth, additional, Longmore, Danielle, additional, Dent, Glynis, additional, Corpus, Sumaria, additional, Kirkwood, Marie, additional, Svenson, Stacey, additional, van Dokkum, Paula, additional, Chitturi, Sridhar, additional, Thomas, Sujatha, additional, Eades, Sandra, additional, Stone, Monique, additional, Harris, Mark, additional, Inglis, Chrissie, additional, Dempsey, Karen, additional, Dowden, Michelle, additional, Lynch, Michael, additional, Boyle, Jacqueline, additional, Sayers, Sue, additional, Shaw, Jonathan, additional, Zimmet, Paul, additional, and O’Dea, Kerin, additional
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- 2013
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17. 1365-P: Type 2 Diabetes after Gestational Diabetes, a High-Risk Population.
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WOOD, ANNA, BOYLE, JACQUELINE, BARZI, FEDERICA, BARR, ELIZABETH L., HARE, MATTHEW J.I., TITMUSS, ANGELA, DEATH, ELIZABETH, KIRKWOOD, MARIE, SIMMONDS, ALISON, MOORE, ELIZABETH M., OATS, JEREMY, MCINTYRE, DAVID, ZIMMET, PAUL Z., BROWN, ALEX D., SHAW, JONATHAN E., and MAPLE-BROWN, LOUISE J.
- Abstract
Aboriginal and Torres Strait Islander women have high rates of gestational diabetes (GDM). The Pregnancy And Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study is a prospective longitudinal cohort of women with type 2 diabetes (T2D), GDM or normoglycemia in pregnancy in the Northern Territory, Australia. In this analysis we report progression to prediabetes and T2D at 2.5 years [range 2.1, 3] postpartum in a subgroup of Aboriginal and Europid women with GDM and normoglycemia in pregnancy (n=337). Women with pre-existing T2D were excluded. Data were analysed using Fisher's exact tests. Among Aboriginal women with GDM we assessed predictions for progression using multivariate logistic regression. Aboriginal women with GDM (n=111) were younger than Europid women with GDM (n=104) (29 years (SD 5.9) vs. 32 (5.6) p<0.01), with similar first trimester BMI (28.9 kg/m
2 (SD 7.2) vs. 28.5 (6.7) p=0.64). Of Aboriginal women with GDM, 24 (22%) progressed to T2D and 12 (11%) to prediabetes. Of Aboriginal women with normoglycemia (n=60), 1 (2%) progressed to T2D and 1 (2%) to prediabetes (p<0.01 for combined outcome vs. GDM women). Of Europid women with GDM, none progressed to T2D and 4 (4%) to prediabetes and of those with normoglycemia (n=62) none progressed to diabetes or prediabetes (p=0.09 vs. GDM women). Among Aboriginal women with GDM, factors associated with postpartum diabetes or prediabetes were age (OR 1.11, 1.03-1.2) and, after adjusting for age: severity of GDM (higher fasting plasma glucose (per 1 mmol/L OR 2.11, 1.23-3.62), use of insulin (OR 3.20, 1.35-7.6)) and higher first trimester BMI (per 3 kg/m2 OR 1.22, 1.01-1.47). Not smoking was protective (OR 0.35, 0.14-0.90), although any breastfeeding at 6-months postpartum was not (OR 0.95, 0.36-2.47). To our knowledge this is the only prospective study of Aboriginal and Torres Strait Islander women with GDM. We report the highest rates in the world of T2D after GDM at 2.5 years postpartum, highlighting a need for targeted interventions in this high-risk population. Disclosure: A. Wood: None. J. Boyle: None. F. Barzi: None. E.L. Barr: None. M.J.I. Hare: None. A. Titmuss: None. E. Death: None. M. Kirkwood: None. A. Simmonds: None. E.M. Moore: None. J. Oats: None. D. McIntyre: Other Relationship; Self; Novo Nordisk A/S. P.Z. Zimmet: None. A.D. Brown: None. J.E. Shaw: Advisory Panel; Self; AstraZeneca, Merck Sharp & Dohme Corp., Mylan, Sanofi. Research Support; Self; AstraZeneca. Speaker's Bureau; Self; Eli Lilly and Company, Mylan. L.J. Maple-Brown: None. [ABSTRACT FROM AUTHOR]- Published
- 2020
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18. Maternal body mass index, excess gestational weight gain, and diabetes are positively associated with neonatal adiposity in the Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study.
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Lee, I‐Lynn, Barzi, Federica, Kirkwood, Marie, Hampton, Vanya, Graham, Sian, O'Dea, Kerin, Longmore, Danielle K., Barr, Elizabeth L.M., Whitbread, Cherie, Maple‐Brown, Louise J., Van Dokkum, Paula, Oats, Jeremy, McIntyre, H. David, Shaw, Jonathan E., Connors, Christine, Boyle, Jacqueline A., Catalano, Patrick, and Brown, Alex D.H.
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HYPERGLYCEMIA ,ADIPOSE tissues ,CEPHALOMETRY ,CHILD health services ,GESTATIONAL diabetes ,ETHNIC groups ,GESTATIONAL age ,INDIGENOUS peoples ,LONGITUDINAL method ,MATERNAL age ,MATHEMATICAL models ,MULTIVARIATE analysis ,TYPE 2 diabetes ,WEIGHT gain in pregnancy ,SMOKING ,THEORY ,EDUCATIONAL attainment ,BODY mass index ,PARITY (Obstetrics) ,CHILDREN ,DISEASE risk factors - Abstract
Summary: Background: In‐utero exposures likely influence the onset and severity of obesity in youth. With increasing rates of type 2 diabetes mellitus (T2DM) and maternal adiposity in pregnancy globally, it is important to assess the impact of these factors on neonatal adipose measures. Objectives: To evaluate the contribution of maternal ethnicity, body mass index (BMI), gestational weight gain, and hyperglycaemia to neonatal adiposity. Methods: Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) is a longitudinal cohort study of Australian mother and neonate pairs. In this analysis, Indigenous (n = 519) and Europid (n = 358) women were included, of whom 644 had hyperglycaemia (type 2 diabetes [T2DM], diabetes in pregnancy [DIP], or gestational diabetes [GDM]). Associations between maternal ethnicity, hyperglycaemia, BMI and gestational weight gain, and the neonatal outcomes of length, head circumference, sum of skinfolds, total body fat, and percentage body fat were examined. Models were adjusted for maternal age, smoking status, parity, education, neonatal gender, and gestational age. Results: Among those with hyperglycaemia in pregnancy, Indigenous women had a higher proportion of T2DM and DIP (36%, 13%) compared with Europid women (4%, 3%). In multivariate analysis, maternal T2DM (compared with no hyperglycaemia), BMI during pregnancy, and excess compared with appropriate gestational weight gain, were significantly associated with greater neonatal measures. DIP was associated with greater sum of skinfolds, total body fat, and percentage body fat. Indigenous ethnicity was associated with greater sum of skinfolds. Conclusions: Maternal BMI, excess gestational weight gain, and hyperglycaemia operated as independent factors influencing neonatal adiposity. Interventions addressing these factors are needed to reduce neonatal adiposity. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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19. Cohort Profile: The Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) Study.
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Lee, I-Lynn, Purbrick, Brydie, Barzi, Federica, Brown, Alex, Connors, Christine, Whitbread, Cherie, Moore, Elizabeth, Kirkwood, Marie, Simmonds, Alison, Dokkum, Paula van, van Dokkum, Paula, Death, Elizabeth, Svenson, Stacey, Graham, Sian, Hampton, Vanya, Kelaart, Joanna, Longmore, Danielle, Titmuss, Angela, Boyle, Jacqueline, and Brimblecombe, Julie
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GESTATIONAL diabetes ,HIP joint ,PUERPERIUM ,PRENATAL care - Published
- 2018
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20. Improving postpartum screening after diabetes in pregnancy: Results of a pilot study in remote Australia
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Alex Brown, Federica Barzi, Renae Kirkham, Cherie Whitbread, Christine Connors, Jacqueline Boyle, Paula van Dokkum, Louise J. Maple-Brown, Diana MacKay, Kerin O'Dea, Jonathan E. Shaw, H. David McIntyre, Paul Zimmet, Sian Graham, Jeremy Oats, Marie Kirkwood, Kirkham, Renae, MacKay, Diana, Barzi, Federica, Whitbread, Cherie, Kirkwood, Marie, Graham, Sian, Van Dokkum, Paula, McIntyre, H David, Shaw, Jonathan E, Brown, Alex, O'Dea, Kerin, Connors, Christine, Oats, Jeremy, Zimmet, Paul, Boyle, Jacqueline, and Maple-Brown, Louise
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medicine.medical_specialty ,Telemedicine ,Native Hawaiian or Other Pacific Islander ,Medically Underserved Area ,Pilot Projects ,030209 endocrinology & metabolism ,Prenatal care ,aboriginal ,postpartum period ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Diabetes mellitus ,Northern Territory ,Health Services, Indigenous ,Humans ,Mass Screening ,text messaging ,Medicine ,Maternal Health Services ,030212 general & internal medicine ,postpartum screening ,Mass screening ,diabetes ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,Prenatal Care ,Puerperal Disorders ,General Medicine ,medicine.disease ,Quality Improvement ,Diabetes, Gestational ,Clinical research ,Gestation ,Female ,business ,Postpartum period - Abstract
Background: The postpartum period is a critical time to improve health outcomes for Aboriginal women, particularly for those who have chronic conditions. Aims: To assess enhanced support methods (for women following diabetes in pregnancy (DIP)) to improve completion rates of recommended postpartum health checks. Materials and Methods: Fifty-three Aboriginal women in the Northern Territory (NT) were contacted in the postpartum period to encourage medical check-ups.Messages were delivered through phone (call or text messages) or other methods (Facebook or email). The primary outcome was postpartum blood glucose testing (oral glucose tolerance testing (OGTT), random or fasting glucose and HbA1c). Results: Establishing contact with women was difficult. Of 137 messages sent to52 women, 22 responded (42%). Phone was the most common contact method with successful contact made from 16 of 119 (13%) attempts. Rates of postpartum OGTT completion were higher in the group successfully contacted (32% vs 7%). However, for any postpartum glucose testing (including OGTT and HbA1c) rates were 25 of 42 (60%) and neither success in making contact nor the contact method was associated with higher rates. Conclusions: The small sample size limits our conclusions; however, results highlight that engaging remote women postpartum is difficult. While rates of postpartum OGTT completion differed according to successful contacts, rates of any postpartum blood glucose testing did not. Further research is needed to explore feasible intervention methods to improve postpartum screening after a pregnancy complicated by diabetes. Refereed/Peer-reviewed
- Published
- 2018
21. Associations of gestational diabetes and type 2 diabetes during pregnancy with breastfeeding at hospital discharge and up to 6 months: the PANDORA study
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Paul Zimmet, Eyvette Hawthorne, Elizabeth L M Barr, Kerin O'Dea, Jeremy Oats, Marie Kirkwood, Harold David McIntyre, Jonathan E. Shaw, Alyce N. Wilson, Federica Barzi, I-Lynn Lee, Alex Brown, Alison Simmonds, Christine Connors, Louise J. Maple-Brown, Danielle K. Longmore, Jacqueline Boyle, Paula van Dokkum, Longmore, Danielle K, Barr, Elizabeth LM, Wilson, Alyce N, Barzi, Federica, Kirkwood, Marie, Simmonds, Alison, Lee, I Lynn, Hawthorne, Eyvette, Van Dokkum, Paula, Connors, Christine, Boyle, Jacqueline A, Zimmet, Paul, O'Dea, Kerin, Oats, Jeremy, McIntyre, Harold D, Brown, Alex DH, Shaw, Jonathan E, and Maple-Brown, Louise J
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0301 basic medicine ,medicine.medical_specialty ,breastfeeding ,Endocrinology, Diabetes and Metabolism ,Breastfeeding ,030209 endocrinology & metabolism ,Type 2 diabetes ,diabetes associated with pregnancy ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Diabetes mellitus ,Internal Medicine ,medicine ,Humans ,diabetes ,Obstetrics ,business.industry ,medicine.disease ,Obesity ,Indigenous ,Hospitals ,Gestational diabetes ,Diabetes, Gestational ,030104 developmental biology ,Breast Feeding ,Diabetes Mellitus, Type 2 ,Hyperglycemia ,Cohort ,intergenerational ,Female ,business ,Breast feeding - Abstract
Aims/hypothesis: Women with gestational diabetes mellitus (GDM) and obesity experience lower rates of breastfeeding. Little is known about breastfeeding among mothers with type 2 diabetes. Australian Indigenous women have a high prevalence of type 2 diabetes in pregnancy. We aimed to evaluate the association of hyperglycaemia, including type 2 diabetes, with breastfeeding outcomes. Methods: Indigenous (n = 495) and non-Indigenous (n = 555) participants of the Pregnancy And Neonatal Diabetes Outcomes in Remote Australia (PANDORA) cohort included women without hyperglycaemia in pregnancy (n = 222), with GDM (n = 684) and with type 2 diabetes (n = 144). The associations of hyperglycaemia in pregnancy and breastfeeding at hospital discharge, 6 weeks and 6 months post-partum were evaluated with logistic regression, after adjustment for maternal obesity, ethnicity, maternal and neonatal characteristics. Results: Indigenous women were more likely to predominantly breastfeed at 6 weeks across all levels of hyperglycaemia. Compared with women with no hyperglycaemia in pregnancy, women with type 2 diabetes had lower odds for exclusive breastfeeding at discharge (adjusted OR for exclusive breastfeeding 0.4 [95% CI 0.2, 0.8] p = 0.006). At 6 weeks and 6 months, the relationship between type 2 diabetes and predominant breastfeeding was not statistically significant (6 weeks 0.7 [0.3, 1.6] p = 0.40, 6 months 0.8 [0.4, 1.6] p = 0.60). Women with gestational diabetes were as likely to achieve predominant breastfeeding at 6 weeks and 6 months as women without hyperglycaemia in pregnancy. Conclusions/interpretation: Indigenous women had high rates of breastfeeding. Women with type 2 diabetes had difficulty establishing exclusive breastfeeding at hospital discharge. Further research is needed to assess the impact on long-term breastfeeding outcomes Refereed/Peer-reviewed
- Published
- 2020
22. Cord blood metabolic markers are strong mediators of the effect of maternal adiposity on fetal growth in pregnancies across the glucose tolerance spectrum: the PANDORA study
- Author
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Jonathan E. Shaw, Christine Connors, Danielle K. Longmore, Louise J. Maple-Brown, H. David McIntyre, Michael Lynch, Kerin O'Dea, Elizabeth L M Barr, Zhong X. Lu, Paul Zimmet, Jeremy Oats, Marie Kirkwood, Federica Barzi, Vanya Hampton, Alex Brown, Jacqueline Boyle, I-Lynn Lee, Lee, I-Lynn, Barr, Elizabeth LM, Longmore, Danielle, Barzi, Federica, Brown, Alex DH, Connors, Christine, Boyle, Jacqueline A, Kirkwood, Marie, Hampton, Vanya, Lynch, Michael, Lu, Zhong X, O'Dea, Kerin, Oats, Jeremy, McIntyre, H David, Zimmet, Paul, Shaw, Jonathan E, and Maple-Brown, Louise J
- Subjects
Male ,0301 basic medicine ,Endocrinology, Diabetes and Metabolism ,Pregnancy in Diabetics ,Type 2 diabetes ,Body Mass Index ,Cohort Studies ,Fetal Development ,0302 clinical medicine ,Pregnancy ,Birth Weight ,fetal hyperinsulinaemia ,Adiposity ,Obstetrics ,Pregnancy Outcome ,Fetal Blood ,Prognosis ,Gestational diabetes ,Cord blood ,cord blood ,Female ,type 2 diabetes ,gestational diabetes ,diabetes in pregnancy ,Adult ,medicine.medical_specialty ,Cord ,neonatal adiposity ,neonatal fat mass ,030209 endocrinology & metabolism ,Young Adult ,03 medical and health sciences ,Venous Cord Blood ,Diabetes mellitus ,Glucose Intolerance ,Internal Medicine ,medicine ,Humans ,Obesity ,business.industry ,Australia ,Infant, Newborn ,medicine.disease ,Pregnancy Complications ,Diabetes, Gestational ,Glucose ,030104 developmental biology ,Diabetes Mellitus, Type 2 ,Hyperglycemia ,business ,Body mass index ,Biomarkers - Abstract
Aims/hypothesis We aimed to assess associations between cord blood metabolic markers and fetal overgrowth, and whether cord markers mediated the impact of maternal adiposity on neonatal anthropometric outcomes among children born to Indigenous and Non-Indigenous Australian women with normal glucose tolerance (NGT), gestational diabetes mellitus (GDM) and pregestational type 2 diabetes mellitus.Methods From the Pregnancy and Neonatal Outcomes in Remote Australia (PANDORA) study, an observational cohort of 1135mother-baby pairs, venous cord blood was available for 645 singleton babies (49% Indigenous Australian) of women with NGT(n = 129),GDM(n = 419) and type 2 diabetes (n = 97). Cord glucose, triacylglycerol, HDL-cholesterol, C-reactive protein (CRP)and C-peptide were measured. Multivariable logistic and linear regression were used to assess the associations between cord blood metabolic markers and the outcomes of birthweight z score, sum of skinfold thickness (SSF), being large for gestational age(LGA) and percentage of body fat. Pathway analysis assessed whether cord markers mediated the associations between maternal and neonatal adiposity. Results Elevated cord C-peptide was significantly associated with increasing birthweight z score (β 0.57 [95% CI 0.42, 0.71]),SSF (β 0.83 [95% CI 0.41, 1.25]), percentage of body fat (β 1.20 [95% CI 0.69, 1.71]) and risk for LGA [OR 3.14 [95% CI 2.11,4.68]), after adjusting for age, ethnicity and diabetes type. Cord triacylglycerol was negatively associated with birthweight z score for Indigenous Australian women only. No associations between cord glucose, HDL-cholesterol and CRP >0.3 mg/l (2.9 nmol/l)with neonatal outcomes were observed. C-peptide mediated 18% (95% CI 13, 36) of the association of maternal BMI with LGAand 11% (95% CI 8, 17) of the association with per cent neonatal fat. Conclusions/interpretation Cord blood C-peptide is an important mediator of the association between maternal and infant adiposity, across the spectrum of maternal glucose tolerance. Refereed/Peer-reviewed
- Published
- 2020
23. Social and economic factors, maternal behaviours in pregnancy and neonatal adiposity in the PANDORA cohort
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Louise J. Maple-Brown, Federica Barzi, Jacqueline Boyle, Kerin O'Dea, E. L. M. Barr, Christine Connors, Danielle K. Longmore, Jeremy Oats, Marie Kirkwood, Paul Zimmet, H. David McIntyre, I-Lynn Lee, Patrick M. Catalano, Alex Brown, Jonathan E. Shaw, Longmore, Danielle K, Barr, Elizabeth LM, Barzi, Federica, Lee, I Lynn, Kirkwood, Marie, Connors, Christine, Boyle, Jacqueline, O'Dea, Kerin, Zimmet, Paul, Oats, Jeremy, Catalano, Patrick, McIntyre, H David, Brown, Alex DH, Shaw, Jonathan E, and Maple-Brown, Louise J
- Subjects
Male ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Pregnancy in Diabetics ,Body Mass Index ,Cohort Studies ,0302 clinical medicine ,Endocrinology ,Pregnancy ,Birth Weight ,030212 general & internal medicine ,indigenous ,Maternal Behavior ,Adiposity ,diabetes ,Smoking ,Pregnancy Outcome ,General Medicine ,Gestational diabetes ,socio-economic ,Prenatal Exposure Delayed Effects ,Cohort ,Female ,hyperglycaemia in pregnancy ,Cohort study ,Adult ,neonatal adiposity ,Offspring ,Birth weight ,030209 endocrinology & metabolism ,03 medical and health sciences ,Young Adult ,Population Groups ,Internal Medicine ,medicine ,Humans ,Obesity ,business.industry ,Australia ,Infant, Newborn ,nutritional and metabolic diseases ,medicine.disease ,Diabetes, Gestational ,Diabetes Mellitus, Type 2 ,Socioeconomic Factors ,Hyperglycemia ,Smoking cessation ,business ,Body mass index ,Demography - 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 socioeconomic 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 witha 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 inlength, head circumference and fat free mass. Frequent fast food intake remained independently associated with SSF (b-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. Refereed/Peer-reviewed
- Published
- 2019
24. Maternal body mass index, excess gestational weight gain, and diabetes are positively associated with neonatal adiposity in the Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study.
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Longmore DK, Barr ELM, Lee IL, Barzi F, Kirkwood M, Whitbread C, Hampton V, Graham S, Van Dokkum P, Connors C, Boyle JA, Catalano P, Brown ADH, O'Dea K, Oats J, McIntyre HD, Shaw JE, and Maple-Brown LJ
- Subjects
- Adult, Australia, Birth Weight, Cohort Studies, Diabetes Mellitus epidemiology, Female, Gestational Age, Humans, Infant, Newborn, Longitudinal Studies, Male, Mothers, Pregnancy, Risk Factors, Adiposity physiology, Body Mass Index, Diabetes Mellitus physiopathology, Gestational Weight Gain physiology, Hyperglycemia complications
- Abstract
Background: In-utero exposures likely influence the onset and severity of obesity in youth. With increasing rates of type 2 diabetes mellitus (T2DM) and maternal adiposity in pregnancy globally, it is important to assess the impact of these factors on neonatal adipose measures., Objectives: To evaluate the contribution of maternal ethnicity, body mass index (BMI), gestational weight gain, and hyperglycaemia to neonatal adiposity., Methods: Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) is a longitudinal cohort study of Australian mother and neonate pairs. In this analysis, Indigenous (n = 519) and Europid (n = 358) women were included, of whom 644 had hyperglycaemia (type 2 diabetes [T2DM], diabetes in pregnancy [DIP], or gestational diabetes [GDM]). Associations between maternal ethnicity, hyperglycaemia, BMI and gestational weight gain, and the neonatal outcomes of length, head circumference, sum of skinfolds, total body fat, and percentage body fat were examined. Models were adjusted for maternal age, smoking status, parity, education, neonatal gender, and gestational age., Results: Among those with hyperglycaemia in pregnancy, Indigenous women had a higher proportion of T2DM and DIP (36%, 13%) compared with Europid women (4%, 3%). In multivariate analysis, maternal T2DM (compared with no hyperglycaemia), BMI during pregnancy, and excess compared with appropriate gestational weight gain, were significantly associated with greater neonatal measures. DIP was associated with greater sum of skinfolds, total body fat, and percentage body fat. Indigenous ethnicity was associated with greater sum of skinfolds., Conclusions: Maternal BMI, excess gestational weight gain, and hyperglycaemia operated as independent factors influencing neonatal adiposity. Interventions addressing these factors are needed to reduce neonatal adiposity., (© 2019 World Obesity Federation.)
- Published
- 2019
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