The Effect of Race/Ethnicity on Adverse Perinatal Outcomes among Patients with Gestational Diabetes
American Journal of Obstetrics and Gynecology, 07/06/2012
Nguyen BT et al. – Perinatal outcomes among women with GDM differ by race/ethnicity and may be attributed to inherent sociocultural differences that may impact glycemic control, the development of chronic co–morbidities, genetic variability, and variation in access to as well as quantity and quality of prenatal care.Methods
- Retrospective cohort study of 32,193 singleton births among GDMs in California from 2006, using Vital Statistics Birth and Death Certificate and Patient Discharge Data.
- Women were divided by race/ethnicity: White, Black, Hispanic, or Asian.
- Multivariable logistic regression analyzed associations between race/ethnicity and adverse outcomes, controlling for potential confounders.
- Outcomes included: primary cesarean, preeclampisa, neonatal hypoglycemia, preterm delivery, macrosomia, fetal anomaly, respiratory distress syndrome (RDS).
- Compared to other races, Black women had higher odds of preeclampsia [aOR=1.57, 95%CI(1.47–1.95)], neonatal hypoglycemia [aOR=1.79, 95%CI(1.07–3.00)], and preterm delivery <37 weeks [aOR=1.56, 95%CI(1.33–1.83)].
- Asians had the lowest odds of primary cesarean [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 RDS [aOR=0.54, 95%CI(0.40–0.73)].