Trends in Gestational Diabetes at First Live Birth by Race and Ethnicity in the US, 2011-2019

Key PointsQuestionDid gestational diabetes rates change from 2011 to 2019 among individuals at first live birth in the US, and were there differences by race and ethnicity subgroups? FindingsIn this serial, population-based, cross-sectional study of 12610235 individuals at first live birth aged 15 to 44 years, the age-standardized gestational diabetes rate increased from 47.6 to 63.5 per 1000 live births from 2011 to 2019. Rates increased in all racial and ethnic subgroups; in 2019, Asian Indian individuals had the highest gestational diabetes rate (129.1 per 1000 live births). MeaningGestational diabetes rates among individuals with a singleton first live birth increased across all race and ethnicity subgroups in the US from 2011 to 2019. ImportanceGestational diabetes is associated with adverse maternal and offspring outcomes. ObjectiveTo determine whether rates of gestational diabetes among individuals at first live birth changed from 2011 to 2019 and how these rates differ by race and ethnicity in the US. Design, Setting, and ParticipantsSerial cross-sectional analysis using National Center for Health Statistics data for 12610235 individuals aged 15 to 44 years with singleton first live births from 2011 to 2019 in the US. ExposuresGestational diabetes data stratified by the following race and ethnicity groups: Hispanic/Latina (including Central and South American, Cuban, Mexican, and Puerto Rican); non-Hispanic Asian/Pacific Islander (including Asian Indian, Chinese, Filipina, Japanese, Korean, and Vietnamese); non-Hispanic Black; and non-Hispanic White. Main Outcomes and MeasuresThe primary outcomes were age-standardized rates of gestational diabetes (per 1000 live births) and respective mean annual percent change and rate ratios (RRs) of gestational diabetes in non-Hispanic Asian/Pacific Islander (overall and in subgroups), non-Hispanic Black, and Hispanic/Latina (overall and in subgroups) individuals relative to non-Hispanic White individuals (referent group). ResultsAmong the 12610235 included individuals (mean [SD] age, 26.3 [5.8] years), the overall age-standardized gestational diabetes rate significantly increased from 47.6 (95% CI, 47.1-48.0) to 63.5 (95% CI, 63.1-64.0) per 1000 live births from 2011 to 2019, a mean annual percent change of 3.7% (95% CI, 2.8%-4.6%) per year. Of the 12610235 participants, 21% were Hispanic/Latina (2019 gestational diabetes rate, 66.6 [95% CI, 65.6-67.7]; RR, 1.15 [95% CI, 1.13-1.18]), 8% were non-Hispanic Asian/Pacific Islander (2019 gestational diabetes rate, 102.7 [95% CI, 100.7-104.7]; RR, 1.78 [95% CI, 1.74-1.82]), 14% were non-Hispanic Black (2019 gestational diabetes rate, 55.7 [95% CI, 54.5-57.0]; RR, 0.97 [95% CI, 0.94-0.99]), and 56% were non-Hispanic White (2019 gestational diabetes rate, 57.7 [95% CI, 57.2-58.3]; referent group). Gestational diabetes rates were highest in Asian Indian participants (2019 gestational diabetes rate, 129.1 [95% CI, 100.7-104.7]; RR, 2.24 [95% CI, 2.15-2.33]). Among Hispanic/Latina participants, gestational diabetes rates were highest among Puerto Rican individuals (2019 gestational diabetes rate, 75.8 [95% CI, 71.8-79.9]; RR, 1.31 [95% CI, 1.24-1.39]). Gestational diabetes rates increased among all race and ethnicity subgroups and across all age groups. Conclusions and RelevanceAmong individuals with a singleton first live birth in the US from 2011 to 2019, rates of gestational diabetes increased across all racial and ethnic subgroups. Differences in absolute gestational diabetes rates were observed across race and ethnicity subgroups. This cross-sectional analysis uses data from the National Center for Health Statistics to quantify annual rates of gestational diabetes in individuals at first live birth among Hispanic/Latina, non-Hispanic Asian/Pacific Islander, non-Hispanic Black, and non-Hispanic White individuals in the US from 2011 to 2019.

Automated summary

The gestational diabetes rates increased among individuals with a singleton first live birth in the US from 2011 to 2019, with differences observed across racial and ethnic subgroups. This cross-sectional study used data from the National Center for Health Statistics to analyze these trends.