Racial/Ethnic Differences in Gestational Diabetes Prevalence and Contribution of Common Risk Factors

Pu, Jia; Zhao, Beinan; Wang, Elsie J.; Nimbal, Vani; Osmundson, Sarah S.; Kunz, Liza; Popat, Rita A.; Chung, Sukyung; Palaniappan, Latha

doi:10.1111/ppe.12209

Cited by 147 publications

(128 citation statements)

References 25 publications

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“…Nine reported an increased association with GDM for South Asian women compared with White women . Three found a decreased association . One found an increased association for South Asian women in unadjusted results .…”

Section: Resultsmentioning

confidence: 94%

“…Thirteen studies reported data for maternal pre‐pregnancy weight, BMI, SFT and serum leptin levels . Nine reported an increased association with GDM for South Asian women compared with White women .…”

Section: Resultsmentioning

confidence: 99%

“…The other found that South Asian women had a higher OR of GDM; however, following adjustment, the adjusted OR (AOR) decreased to less than that of White women . Two studies only presented adjusted results: one found the AOR was higher in South Asian women , and the other found that South Asian women had a lower AOR of GDM than did White women at the same BMI (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Pu et al . found that the odds of GDM increased from 1.17 (1.5, 2.0) at BMI ≥ 25 kg m −2 to 1.9 (1.7, 2.2) at BMI ≥ 23 kg m −2 . Of all the studies that considered GDM as an outcome where maternal BMI was categorized as the exposure, Pu et al .…”

Section: Discussionmentioning

confidence: 99%

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Effects of maternal anthropometrics on pregnancy outcomes in South Asian women: a systematic review

et al. 2018

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SummaryAimThis systematic review investigates associations between maternal pre‐pregnancy/early‐pregnancy anthropometrics (e.g. weight and body fat), anthropometric change and pregnancy outcomes in South Asian and White women.MethodsTwelve electronic literature databases, reference lists and citations of all included studies were searched. Observational studies published in the English language were included. Descriptive synthesis was used to summarize the evidence base.ResultsTwenty‐two studies met the inclusion criteria (403,609 births [351,856 White and 51,753 South Asian]). Nine were prospective cohort studies, nine were retrospective cohort studies and two were cross‐sectional studies. Results suggested that in South Asian women, maternal pre‐pregnancy/early‐pregnancy anthropometrics were associated with anthropometric change, birthweight, mode of delivery and gestational diabetes mellitus (GDM). Gestational anthropometric change was found to be associated with GDM. There was limited evidence to suggest that there may be associations between maternal pre‐anthropometrics/early anthropometrics and hypertensive disorders, stillbirth, congenital anomalies, post‐natal weight retention and post‐natal impaired glucose tolerance. The evidence suggested a combined effect of pre‐pregnancy/early‐pregnancy anthropometrics and gestational anthropometric change on both GDM and post‐natal weight retention.ConclusionThe increased risk of adverse pregnancy outcomes in South Asian women should be considered in guidelines for weight management before and during pregnancy.

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effects of maternal anthropometrics on pregnancy outcomes in South Asian women: a systematic review

et al. 2018

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“…Zhuang ethnicity was found to be near-significantly associated with a lower risk of NODB in this study. Given that Guangxi is the largest Zhuang autonomous region in China, and different genetics among different race and ethnic groups contributing to obesity and type 2 diabetes have been documented [21,22,23], a different genetic background may explain some of the differences seen in this study from others in China/Asia and abroad. In Japan, non-obese type 2 diabetes patients have been demonstrated as having a stronger genetic predisposition to type 2 diabetes than obese type 2 diabetes [24].…”

Section: Discussionmentioning

confidence: 90%

Non-Obese Diabetes and Its Associated Factors in an Underdeveloped Area of South China, Guangxi

Tang

Fang

Huang

et al. 2016

IJERPH

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Background: Little research has been conducted on the prevalence of diabetes mellitus in underdeveloped areas in China, especially stratified into obesity and non-obese diabetes. The aim of the present study was to investigate the prevalence and associated factors of non-obese diabetes in an underdeveloped area in South China, Guangxi. Methods: Data derived from the Chinese Health and Nutrition Survey 2010–2012 involved a sample of 3874 adults from Guangxi. Questionnaires and oral glucose-tolerance tests were conducted, and fasting and 2-h glucose levels and serum lipids were measured. Logistic regression analysis was performed to assess associated factors for non-obese diabetes. Results: 68.2% and 62.2% of instances of newly detected diabetes were those of non-obese diabetes based on BMI (NODB) and based on WC (NODW), respectively. The male sex, an age older than 50 years, lower education, hypertension, and hypertriglyceridemia were significantly associated with a higher risk of both NODB and NODW, while some associated factors for NODB were found different from those associated with NODW, and an interaction effect was found to increase the risk of NODW. Conclusions: Our study indicated that non-obese diabetes was highly prevalent in an underdeveloped area of South China. Non-obese diabetes should be considered for increased public attention in these areas.

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

Shah

Wang

Freaney

et al. 2021

JAMA

186

140

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OBJECTIVE To 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 PARTICIPANTS Serial cross-sectional analysis using National Center for Health Statistics data for 12 610 235 individuals aged 15 to 44 years with singleton first live births from 2011 to 2019 in the US.EXPOSURES Gestational 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). RESULTS Among the 12 610 235 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 12 610 235 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,). 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 RELEVANCE Among 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.

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Racial/Ethnic Differences in Gestational Diabetes Prevalence and Contribution of Common Risk Factors

Abstract: Overweight/obesity, advanced maternal age, family history of type 2 diabetes, and foreign-borne status are important risk factors for GDM. The relative contributions of these risk factors differ by race/ethnicity, mainly due to differences in population prevalence of these risk factors.

Cited by 147 publications

References 25 publications

Effects of maternal anthropometrics on pregnancy outcomes in South Asian women: a systematic review

Effects of maternal anthropometrics on pregnancy outcomes in South Asian women: a systematic review

Non-Obese Diabetes and Its Associated Factors in an Underdeveloped Area of South China, Guangxi

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

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