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Cited by 21Chronic Kidney Disease and DiabetesGestational Diabetes Research and ManagementDiabetes, Cardiovascular Risks, and Lipoproteins

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Risk of kidney disease following a pregnancy complicated by diabetes: a longitudinal, population-based data-linkage study among Aboriginal women in the Northern Territory, Australia

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Hare, Matthew J. L., Maple-Brown, Louise J., Shaw, Jonathan E., Boyle, Jacqueline A., Lawton, Paul D., Barr, Elizabeth L. M., Guthridge, Steven, Webster, Vanya, Hampton, Denella, Singh, Gurmeet, Dyck, Roland F., Barzi, Federica·2023·Diabetologia
DOI 10.1007/s00125-023-05868-wPMC PMC10036460
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Abstract

Aims/hypothesis: The aim of this work was to investigate the risk of developing chronic kidney disease (CKD) or end-stage kidney disease (ESKD) following a pregnancy complicated by gestational diabetes mellitus (GDM) or pre-existing diabetes among Aboriginal women in the Northern Territory (NT), Australia. Methods: We undertook a longitudinal study of linked healthcare datasets. All Aboriginal women who gave birth between 2000 and 2016 were eligible for inclusion. Diabetes status in the index pregnancy was as recorded in the NT Perinatal Data Collection. Outcomes included any stage of CKD and ESKD as defined by ICD-10 coding in the NT Hospital Inpatient Activity dataset between 2000 and 2018. Risk was compared using Cox proportional hazards regression. Results: Among 10,508 Aboriginal women, the mean age was 23.1 (SD 6.1) years; 731 (7.0%) had GDM and 239 (2.3%) had pre-existing diabetes in pregnancy. Median follow-up was 12.1 years. Compared with women with no diabetes during pregnancy, women with GDM had increased risk of CKD (9.2% vs 2.2%, adjusted HR 5.2 [95% CI 3.9, 7.1]) and ESKD (2.4% vs 0.4%, adjusted HR 10.8 [95% CI 5.6, 20.8]). Among women with pre-existing diabetes in pregnancy, 29.1% developed CKD (adjusted HR 10.9 [95% CI 7.7, 15.4]) and 9.9% developed ESKD (adjusted HR 28.0 [95% CI 13.4, 58.6]). Conclusions/interpretation: Aboriginal women in the NT with GDM or pre-existing diabetes during pregnancy are at high risk of developing CKD and ESKD. Pregnancy presents an important opportunity to identify kidney disease risk. Strategies to prevent kidney disease and address the social determinants of health are needed. Graphical abstract:

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  • Women with gestational diabetes mellitus have increased risk of future type 2 diabetes, kidney disease and cardiovascular disease.

    “Women with gestational diabetes mellitus have increased risk of future type 2 diabetes, kidney disease and cardiovascular disease. 4 , 5 , 6 , 7”

    From Australasian Diabetes in Pregnancy Society ( ADIPS ) 2025 consensus recommendations for the screening, diagnosis and classification of gestational diabetes (2025) · cites this paper as [6]

    The Results report increased future CKD and ESKD risk after gestational diabetes among Aboriginal women in the Northern Territory. The Discussion describes subsequent type 2 diabetes in women who developed kidney disease and reports a prior cohort’s postpartum type 2 diabetes findings. Our copy does not report an increased risk of cardiovascular disease after gestational diabetes, and this study’s kidney findings concern a specific population rather than women generally. (LLM, conf=0.88)

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Research works printed but not linked: 25

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Metadata

Authors
Hare, M. J. L., Maple-Brown, L. J., Shaw, J. E., Boyle, J. A., Lawton, P. D., Barr, E. L. M., Guthridge, S., Webster, V., Hampton, D., Singh, G., Dyck, R. F., & Barzi, F.
Affiliations
  • Charles Darwin University (AU)
  • Baker Heart and Diabetes Institute (AU)
  • Eastern Health (AU)
  • The Alfred Hospital (AU)
  • Menzies School of Health Research (AU)
  • University of Saskatchewan (CA)
  • The University of Queensland (AU)
Corresponding author
Hare, Matthew J. L.
ORCID
Venue
Diabetologia
Publisher
Springer Science and Business Media LLC
Published
2023-01-18
Volume
66
Issue
5
Pages
837-846
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
DOI
10.1007/s00125-023-05868-w
PMC
PMC10036460
OpenAlex
W4317209197
Cited by
21
References
3
Citations by year
2026: 6 · 2025: 7 · 2024: 5 · 2023: 3
FWCI
4.06
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetologia (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • Diabetes Australia Research Program (NA)
  • National Health and Medical Research Council (1194698)
  • Australian Academy of Science (NA)
  • Diabetes Australia (NA)
Topics
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
chronic kidney disease, end-stage renal disease, gestational diabetes mellitus, pregestational diabetes, Aboriginal women, kidney disease risk, social determinants of health, Northern Territory
MeSH terms
Adult, Female, Humans, Kidney Failure, Chronic, Longitudinal Studies, Pregnancy, Northern Territory, Diabetes, Gestational, Renal Insufficiency, Chronic, Young Adult

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