The association of non-insulin-dependent diabetes with parity and still-birth occurrence amongst five Pacific populations

Summary Previous reports have shown the prevalence of non-insulin-dependent diabetes to be high amongst several populations living in the South and Central Pacific region, and a number of factors including a sedentary life-style, urban residence, obesity and genetic factors have been implicated in its aetiology. Amongst some populations increasing parity has been shown to be associated with abnormal glucose tolerance, but the cross-sectional data available did not suggest any such association amongst the five Pacific Island populations surveyed. Still-birth rates are high amongst all these populations, particularly so amongst the older women, and several methods of analysis suggest that abnormal glucose tolerance is associated with a significantly increased risk of still-birth. This association appears more marked amongst younger women in all populations, with the overall relative risk of a still-birth occurrence for diabetic women aged less than 45 years being 2.6 (95% confidence interval being 1.4–4.8), and for women aged less than 45 years with impaired glucose tolerance being 2.2 (95% confidence interval being 1.3–3.7). As many of the women diabetic at the time of surveys would not have been during their pregnancies, these risk estimates are probably underestimates. Longitudinal studies may suggest even higher figures. Nonetheless the results of these surveys suggest that the high prevalence of abnormal glucose tolerance in these populations may be at least partly responsible for their high levels of still-birth occurrence.