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1.
BMC Health Serv Res ; 19(1): 726, 2019 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-31640690

RESUMEN

In the original publication of this article [1] an author's name needs to be revised from Katrina Nelson to Adrianne Katrina Nelson.

2.
BMC Health Serv Res ; 18(1): 629, 2018 08 10.
Artículo en Inglés | MEDLINE | ID: mdl-30097012

RESUMEN

BACKGROUND: Native American communities experience greater burden of diabetes than the general population, including high rates of Type 2 diabetes among women of childbearing age. Diabetes in pregnancy is associated with risks to both the mother and offspring, and glycemic control surrounding the pregnancy period is of vital importance. METHODS: A retrospective chart review was conducted at a major Navajo Area Indian Health Service (IHS) hospital, tracking women with pre-existing diabetes who became pregnant between 2010 and 2012. Logistic regression was performed to find patient-level predictors of our desired primary outcome-having hemoglobin A1c (HbA1c) consistently < 8% within 2 years after pregnancy. Descriptive statistics were generated for other outcomes, including glycemic control and seeking timely IHS care. RESULTS: One hundred twenty-two pregnancies and 114 individuals were identified in the dataset. Baseline HbA1c was the only covariate which predicted our primary outcome (OR = 1.821, 95% CI = 1.184-2.801). Examining glycemic control among pregnancies with complete HbA1c data (n = 59), 59% were controlled before, 85% during, and 34% after pregnancy. While nearly all women received care in the immediate postpartum period, only 49% of women visited a primary care provider and 71% had HbA1c testing in the 2 years after pregnancy. CONCLUSIONS: This is the first analysis of outcomes among women with diabetes in pregnancy in Navajo Nation, the largest reservation and tribal health system in the United States. Our findings demonstrate the positive impact of specialized prenatal care in achieving glycemic control during pregnancy, while highlighting the challenges in maintaining glycemic control and continuity of healthcare after pregnancy.


Asunto(s)
Diabetes Mellitus Tipo 2/prevención & control , Indígenas Norteamericanos/etnología , Aceptación de la Atención de Salud/estadística & datos numéricos , Embarazo en Diabéticas/prevención & control , Adolescente , Adulto , Arizona/etnología , Glucemia/metabolismo , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/etnología , Utilización de Instalaciones y Servicios , Femenino , Hemoglobina Glucada/metabolismo , Servicios de Salud del Indígena/estadística & datos numéricos , Humanos , Indígenas Norteamericanos/estadística & datos numéricos , Modelos Logísticos , Persona de Mediana Edad , New Mexico/etnología , Atención Posnatal/estadística & datos numéricos , Embarazo , Embarazo en Diabéticas/sangre , Embarazo en Diabéticas/etnología , Atención Prenatal/estadística & datos numéricos , Estudios Retrospectivos , Estados Unidos , Utah/etnología , Adulto Joven
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