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J Reprod Med. 2003 Aug;48(8):610-6.

Birth outcomes among American Indian/Alaska Native women with diabetes in pregnancy.

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Departments of Pediatrics and Family Medicine, University of Washington, Center for Health Studies, Group Health Cooperative/Permanente, Seattle, Washington, USA.



To describe perinatal outcomes and maternal characteristics among American Indian/Alaska Native (AI/AN) women with diabetes in pregnancy.


A retrospective analysis of live births to AI/AN, African American and white women with diabetes (242,715) during pregnancy for the 1989-1991 period (latest available at the time of study) was conducted utilizing a linked birth/infant death database from the National Center for Health Statistics. AI/AN perinatal outcomes and maternal characteristics were compared to those of African American and white women. Similar analyses compared urban and rural AI/AN populations.


AI/AN women were more likely than white women to receive inadequate prenatal care (10.4%), to have higher rates of pregnancy-induced hypertension (9.1%) and to have significantly lower rates of primary cesarean delivery (16.9% vs. 22.3%). The rate of macrosomia among births to AI/AN women (24.2%) was notably higher as compared to that in the white population (17.9%). Rates of musculoskeletal and chromosomal anomalies were also higher among AI/AN women, 9 and 4, respectively, per 1,000 live births, as compared to 6 and 2 per 1,000 for the white population.


Multiple maternal risk factors and birth outcomes demonstrate the need for further research to evaluate methods of improving care in this population.

[Indexed for MEDLINE]

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