Introduction: Métis people are distinct Indigenous peoples in Canada. The burden of diabetes in pregnancy among Métis women has not been previously evaluated. This study assessed the prevalence, maternal and neonatal health outcomes of diabetes in pregnancy among Métis women compared to non-Métis women.
Methods: A population-based, retrospective cohort study of all singleton births in Alberta from 2006-2016 was conducted. Study outcomes were pre-existing diabetes (PEDM), gestational diabetes mellitus (GDM), and maternal and neonatal outcomes of PEDM and GDM births. Multivariable logistic regression analyses using multilevel random-effects models adjusting for important study covariates (maternal age, insulin use, area of residency, material and social deprivation) were conducted to examine differences in study outcomes between Métis and non-Métis birth cohorts.
Results: A total of 483,300 singleton births were included in the study: 7,977 Métis births, and 475,323 non-Métis births. Births among Métis women had 74% increased odds of having PEDM (aOR: 1.74 95%CI:1.18, 2.58) and 30% increased odds of having GDM (aOR: 1.30 95%CI: 1.08, 1.55) compared to non-Métis women after adjusting for study covariates. Métis women with GDM had increased odds of having a baby large for gestational age (aOR: 1.48 95%CI:1.00, 2.19), but there were no differences for pregnancy-induced hypertension (aOR: 1.50 95%CI: 0.91, 2.48), C-sections (0.82 95%CI: 0.34, 1.96) and preterm birth (aOR: 0.82 95%CI: 0.52, 1.30). Among births with PEDM, there were no differences between Métis and non-Métis for pregnancy induced hypertension (aOR: 1.48 95%CI: 0.71, 2.96), C-sections (aOR: 3.53 95%CI: 0.48, 26.13), babies born large for gestational age (aOR: 0.99 95%CI: 0.50, 1.96), and preterm birth (aOR: 1.30 95%CI: 0.68, 2.51).
Conclusion: The study results highlight important differences between Métis and non-Métis diabetic pregnancies and will be used to inform the development of culturally appropriate prenatal health services for Métis women with diabetes in pregnancy.
Omolara Sanni– Post-Doctoral Fellow, Department of Obstetrics and Gynecology, University of Alberta
Jesus Serrano Lomelin– Post-Doctoral Fellow, Department of Obstetrics & Gynecology, University of Alberta
Ashton James– Senior Manager, Metis Nation of Alberta
Reagan Bartel– Health Director, Metis Nation of Alberta
Claire Cordingley– Research Coordinator, Metis Nation of Alberta
Dean Eurich– Professor, School of Public Health, University of Alberta
Maria Ospina– Assistant Professor, University of Alberta