TY - JOUR
T1 - The effect of race/ethnicity on adverse perinatal outcomes among patients with gestational diabetes mellitus
AU - Nguyen, Brian T.
AU - Cheng, Yvonne W.
AU - Snowden, Jonathan M.
AU - Esakoff, Tania F.
AU - Frias, Antonio E.
AU - Caughey, Aaron B.
N1 - Funding Information:
Supported in part by grant number WRHR K12 HD01262 from the National Institute of Child Health and Human Development (Y.W.C.) and by grant number R24 DK0909640-01 from the National Institute of Diabetes and Digestive and Kidney Diseases , grant number P51 RR00163 from the National Center for Research Resources , grant number R01 HD071068-01 from the National Institute of Child Health and Human Development , and grant number R21 HD0688896-01 from the National Institute of Child Health and Human Development (A.E.F.).
PY - 2012/10
Y1 - 2012/10
N2 - Objective: The purpose of this study was to determine racial/ethnic differences in perinatal outcomes among women with gestational diabetes mellitus. Study Design: We conducted a retrospective cohort study of 32,193 singleton births among women with gestational diabetes mellitus in California from 2006, using Vital Statistics Birth and Death Certificate and Patient Discharge Data. Data were divided by race/ethnicity: white, black, Hispanic, or Asian. Multivariable logistic regression was used to analyze associations between race/ethnicity and adverse outcomes that were controlled for potential confounders. Outcomes included primary cesarean delivery, preeclampsia, neonatal hypoglycemia, preterm delivery, macrosomia, fetal anomaly, and respiratory distress syndrome. Results: Compared with women in other races, black women had higher odds of preeclampsia (adjusted odds ratio [aOR], 1.57; 95% confidence interval [CI], 1.47-1.95), neonatal hypoglycemia (aOR, 1.79; 95% CI, 1.07-3.00), and preterm delivery <37 weeks' gestation (aOR, 1.56; 95% CI, 1.33-1.83). Asian women had the lowest odds of primary cesarean delivery (aOR, 0.75; 95% CI, 0.69-0.82), large-for-gestational-age infants (aOR, 0.40; 95% CI, 0.33-0.48), and neonatal respiratory distress syndrome (aOR, 0.54; 95% CI, 0.40-0.73). Conclusion: Perinatal outcomes among women with gestational diabetes mellitus differ by race/ethnicity and may be attributed to inherent sociocultural differences that may impact glycemic control, the development of chronic comorbidities, genetic variability, and variation in access to prenatal care, and quantity and quality of prenatal care.
AB - Objective: The purpose of this study was to determine racial/ethnic differences in perinatal outcomes among women with gestational diabetes mellitus. Study Design: We conducted a retrospective cohort study of 32,193 singleton births among women with gestational diabetes mellitus in California from 2006, using Vital Statistics Birth and Death Certificate and Patient Discharge Data. Data were divided by race/ethnicity: white, black, Hispanic, or Asian. Multivariable logistic regression was used to analyze associations between race/ethnicity and adverse outcomes that were controlled for potential confounders. Outcomes included primary cesarean delivery, preeclampsia, neonatal hypoglycemia, preterm delivery, macrosomia, fetal anomaly, and respiratory distress syndrome. Results: Compared with women in other races, black women had higher odds of preeclampsia (adjusted odds ratio [aOR], 1.57; 95% confidence interval [CI], 1.47-1.95), neonatal hypoglycemia (aOR, 1.79; 95% CI, 1.07-3.00), and preterm delivery <37 weeks' gestation (aOR, 1.56; 95% CI, 1.33-1.83). Asian women had the lowest odds of primary cesarean delivery (aOR, 0.75; 95% CI, 0.69-0.82), large-for-gestational-age infants (aOR, 0.40; 95% CI, 0.33-0.48), and neonatal respiratory distress syndrome (aOR, 0.54; 95% CI, 0.40-0.73). Conclusion: Perinatal outcomes among women with gestational diabetes mellitus differ by race/ethnicity and may be attributed to inherent sociocultural differences that may impact glycemic control, the development of chronic comorbidities, genetic variability, and variation in access to prenatal care, and quantity and quality of prenatal care.
KW - gestational diabetes mellitus
KW - perinatal outcomes
KW - race/ethnicity
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U2 - 10.1016/j.ajog.2012.06.049
DO - 10.1016/j.ajog.2012.06.049
M3 - Article
C2 - 22818875
AN - SCOPUS:84866949171
SN - 0002-9378
VL - 207
SP - 322.e1-322.e6
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 4
ER -