THE EPIDEMIOLOGY OF DIABETES IN PREGNANCY AMONG FIRST NATIONS AND NON-FIRST NATIONS WOMEN IN SASKATCHEWAN - 1980 to 2013

Abstract Objectives Because of the immediate and long term consequences of diabetes in pregnancy (DIP) for mother and child, we compared frequencies of gestational diabetes (GDM) and pre-GDM between First Nations (FN) and non-FN people in Saskatchewan from 1980-2009. Methods Using Ministry of Health administrative databases, we conducted a retrospective cohort study of GDM and pre-GDM rates within all FN and non-FN pregnancies in Saskatchewan. Annual crude and 10 year age-adjusted incidence of GDM and pre-GDM were determined as were maternal age specific rates of DIP. Results De-identified data was obtained for 69,176 FN and 344,410 non-FN pregnancies. The crude annual incidence of GDM rose from 1.0% to 6.6% among FN and from 0.4% to 3.6% among non-FN between 1980 and 2009. The crude annual incidence of pre-GDM rose from 0.7% to 2.0% among FN and from 0.4% to 0.9% in non-FN over the same period. The 10 year age standardized incidence of GDM increased from 3.53% in 1980-89 to 8.37% from 2000-09 for FN, and from 1.55% to 3.13% for non-FN. For pre-GDM the corresponding increases were from 1.65% to 3.26% for FN and from 0.5% to 0.91% for non-FN. Both GDM and pre-GDM rates increased with increasing maternal age reaching 10.9% and 8.0% of FN pregnancies, and 7.7% and 1.1% of non-FN pregnancies respectively for mothers 40+. Conclusions The proportion of pregnancies complicated by DIP steadily increased among FN and non-FN in Saskatchewan from 1980-2009, but the incidence of GDM and pre-GDM is 2-3 times higher among FN.