Racial disparities in perinatal outcomes among women with gestational diabetes

J Womens Health (Larchmt). 2012 May;21(5):521-7. doi: 10.1089/jwh.2011.3123. Epub 2012 Jan 4.

Abstract

Background: We sought to evaluate perinatal outcomes by race/ethnicity among women with gestational diabetes mellitus (GDM).

Methods: We conducted a 14-year retrospective cohort study of women with GDM. Selected perinatal outcomes were examined. Unadjusted and adjusted prevalence ratios (PR, aPR) of perinatal outcomes, comparing Hispanic and African American women with Caucasian women, were calculated.

Results: Hispanics comprised 54% of the 1018 woman cohort. Half received medical management of GDM (52%), more than African Americans (45%) or Caucasians (39%)(p<0.05). Compared with Caucasians, Hispanics had fewer deliveries <37 weeks (aPR 0.58, 95% confidence interval [CI] 0.42-0.81), less gestational hypertension (aPR 0.43, 95% CI 0.22-0.83), larger median birth weight infants (3453 g vs 3291 g, p<0.05), and greater risk of shoulder dystocia (aPR 3.52, 95% CI 1.30-9.50). Hispanic women had fewer adverse outcomes overall compared with Caucasian or African American women.

Conclusions: We report differences between Hispanic and Caucasian women with GDM. Treatment to achieve glycemic control and reduce adverse outcomes may differ by race/ethnicity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Asian People
  • Birth Weight
  • Black or African American / psychology
  • Black or African American / statistics & numerical data
  • Cohort Studies
  • Diabetes, Gestational / diagnosis
  • Diabetes, Gestational / ethnology*
  • Diabetes, Gestational / therapy
  • Female
  • Glycated Hemoglobin / analysis
  • Health Knowledge, Attitudes, Practice* / ethnology
  • Healthcare Disparities / ethnology*
  • Hispanic or Latino / psychology
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Insulin Resistance / ethnology
  • North Carolina / epidemiology
  • Pregnancy
  • Pregnancy Outcome / ethnology
  • Prevalence
  • Retrospective Studies
  • White People / psychology
  • White People / statistics & numerical data

Substances

  • Glycated Hemoglobin A