Perinatal outcomes in patients with gestational diabetes mellitus by race/ethnicity

Abstract

Objective. To determine if racial/ethnic differences exist in perinatal outcomes in women with gestational diabetes mellitus (GDM).

Methods. This is a retrospective cohort study of singleton pregnancies with GDM cared for by the Sweet Success: California Diabetes and Pregnancy Program (CDAPP) between 2001 and 2004 at inpatient obstetric and neonatal services in California. There were a total of 26,411 women with gestational diabetes who were subgrouped by four races/ethnicities: Caucasian, African-American, Latina, and Asian. The chi-squared test was used to compare the dichotomous outcomes and p < 0.05 was used to indicate statistical significance. Multivariable logistic regression analyses were performed to control for potential confounders. Perinatal outcomes, including severity of GDM, cesarean delivery (CD), birthweight, preterm birth, intrauterine fetal demise (IUFD) and neonatal intensive care unit (NICU) admission were compared.

Results. Compared to Caucasians, African-Americans had higher odds of primary CD [aOR = 1.29, 95% CI (1.05–1.59)] while lower odds were seen in Latinas [aOR = 0.84, 95% CI (0.75–0.94)] and Asians [aOR = 0.86, 95% CI (0.77–0.96)]. Asians had lower odds [aOR = 0.58 (95% CI 0.48–0.70)] of birthweight >4000 g. African-Americans had highest odds of IUFD [aOR = 5.93 95% CI (1.73–20.29)]. There were no differences in NICU admission.

Conclusion. Perinatal outcomes in women diagnosed with GDM differ by racial/ethnic group. Such variation can be used to individually counsel women with GDM.

Keywords:

• Gestational diabetes mellitus
• race
• ethnicity
• perinatal
• outcome

Acknowledgements

The authors thank Maternal, Child and Adolescent Health Division of the California Department of Public Health for providing the data for this study and all of the nurses, dieticians, and other clinicians in the Sweet Success Program of California. Aaron B. Caughey, MD, PhD is supported by the Robert Wood Johnson Foundation as a Physician Faculty Scholar. The procedures of the study received ethics approval from the University of California, San Francisco Committee on Human Research (IRB#H4117-29046-02 obtained on April 11, 2006).