Gestational diabetes mellitus and pregnancy outcomes among Chinese and South Asian women in Canada

Abstract

Objective: To determine the association between Chinese or South Asian ethnicity and adverse neonatal and maternal outcomes for women with gestational diabetes compared to the general population. Methods: A cohort study was conducted using population-based health care databases in Ontario, Canada. All 35,577 women aged 15–49 with gestational diabetes who had live births between April 2002 and March 2011 were identified. Their delivery hospitalization records and the birth records of their neonates were examined to identify adverse neonatal outcomes and adverse maternal outcomes. Results: Compared to infants of mothers from the general population (55.5%), infants of Chinese mothers had a lower risk of an adverse outcome at delivery (42.9%, adjusted odds ratio 0.63, 95% confidence interval 0.58–0.68), whereas infants of South Asian mothers had a higher risk (58.9%, adjusted odds ratio 1.15, 95% confidence interval 1.07–1.23). Chinese women also had a lower risk of adverse maternal outcomes (32.4%, adjusted odds ratio 0.58, 95% confidence interval 0.54–0.63) compared to general population women (41.2%), whereas the risk for South Asian women was not different (39.4%, adjusted odds ratio 0.94, 95% confidence interval 0.88–1.02) from that of general population women. Conclusions: The risk of complications of gestational diabetes differs significantly between Chinese and South Asian patients and the general population in Ontario. Tailored interventions for gestational diabetes management may be required to improve pregnancy outcomes in high-risk ethnic groups.

Keywords::

• Antenatal care
• endocrinology
• ethnicity

Acknowledgements

The authors would like to thank Fangyun Wu, Institute for Clinical Evaluative Sciences (ICES), who assisted in the statistical analysis of the data.

Declaration of Interest: Drs Chiu and Shah are both supported by the Canadian Institutes of Health Research. This study was supported by ICES, a non-profit research institute funded by the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the MOHLTC is intended or should be inferred.