Journal
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volume 207, Issue 4, Pages -Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2012.06.049
Keywords
gestational diabetes mellitus; perinatal outcomes; race/ethnicity
Categories
Funding
- National Institute of Child Health and Human Development [WRHR K12 HD01262, R01 HD071068-01, R21 HD0688896-01]
- National Institute of Diabetes and Digestive and Kidney Diseases [R24 DK0909640-01]
- National Center for Research Resources [P51 RR00163]
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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, pre-eclampsia, 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.
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