{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:36:11Z","timestamp":1790703371771,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,8,23]],"date-time":"2017-08-23T00:00:00Z","timestamp":1503446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the prevalence of adverse clinical outcomes, the rates of healthcare utilization, and the incidence of post\u2010partum Type 2 diabetes in refugees with gestational diabetes (<jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content>), compared with other immigrants and non\u2010immigrants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A population\u2010based cohort study was conducted using healthcare databases in Ontario, Canada. Over 40\u00a0000 women with <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content> having singleton live births between 2002 and 2014 were identified. We identified <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content> adverse outcomes such as macrosomia, pre\u2010eclampsia and respiratory distress syndrome. Antenatal and newborn healthcare utilization were ascertained. Women were then followed for diagnosis of diabetes post\u2010partum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both refugees and other immigrants had a lower rate than non\u2010immigrants of many adverse <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content> outcomes, including pre\u2010eclampsia [relative risk (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>) 0.65, 95% confidence interval (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 0.44\u20130.95 and 0.61, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.52\u20130.72, respectively], preterm birth (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0.87, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.75\u20130.995 and 0.85, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.80\u20130.91, respectively), and respiratory distress syndrome (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0.83, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.70\u20130.97 and 0.78, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.72\u20130.84, respectively). However, refugees were less likely to attend well\u2010baby care in time for the first routine vaccination (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0.92, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.88\u20130.95). Incidence of post\u2010partum diabetes was high in all groups, but refugee women were at increased risk (hazard ratio 1.23, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.11\u20131.37).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite different circumstances leading to migration, refugees have a similar \u2018healthy immigrant effect\u2019 to other immigrants, with respect to adverse <jats:styled-content style=\"fixed-case\">GDM<\/jats:styled-content> outcomes. However, newborns of refugees were less likely to have well\u2010baby care, and refugee women were also at especially high risk of developing diabetes post\u2010partum. These are both important public health issues.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.13440","type":"journal-article","created":{"date-parts":[[2017,8,5]],"date-time":"2017-08-05T08:16:47Z","timestamp":1501921007000},"page":"1608-1614","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Gestational diabetes care and outcomes for refugee women: a population\u2010based cohort study"],"prefix":"10.1111","volume":"34","author":[{"given":"S.","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Medicine University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z.","family":"Yao","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3598-3628","authenticated-orcid":false,"given":"B. R.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto"},{"name":"Institute for Clinical Evaluative Sciences"},{"name":"Sunnybrook Health Sciences Centre Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.090313"},{"key":"e_1_2_9_3_1","unstructured":"United Nations High Commissioner for Refugees (UNHCR).UNHCR viewpoint: \u2018Refugee\u2019 or \u2018migrant\u2019 \u2013 which is right?Available athttp:\/\/www.unhcr.org\/uk\/news\/latest\/2016\/7\/55df0e556\/unhcr-viewpoint-refugee-migrant-right.htmlLast accessed 27 January 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