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

Abstract

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.

Cardiovascular and Cerebrovascular Disease Mortality in Asian American Subgroups

“…Our findings are also consistent with prior reports of heterogeneity in cardiovascular health and disease outcomes in Asian American subgroups, including in leading causes of death, 10 treatment patterns and outcomes for coronary artery disease, 11 and burden of cardiovascular risk factors among Asian Americans. 5,12 Our findings also align with data showing substantial burden of premature mortality from cardiovascular causes in Asian American subgroups. 13 Differences in burden of risk factors like hypertension, obesity, diabetes, and smoking likely contribute in part to the heterogeneity observed in cardiovascular and cerebrovascular mortality outcomes.…”

“…One analysis of gestational diabetes surveillance in disaggregated Asian American subgroups from the National Center for Health Statistics between 2011 and 2019 revealed a range of gestational diabetes rates, from 54 per 1000 live births in Japanese women, to 129 per 1000 live births in Asian Indian women. 5 As cardiovascular risk factors are not uniformly distributed in Asian American subgroups, understanding cardiovascular and cerebrovascular disease mortality in disaggregated Asian American subgroups is necessary to understand health and disease in these populations.…”

Disparities in Health Care Spending and Utilization Among Black and White Medicaid Enrollees

“…Racial disparities in health care access and health are well documented in the US. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 While expanding health insurance coverage reduces disparities, 9 , 10 , 11 , 12 , 13 , 14 , 15 substantial unexplained variation remains. Prior studies found that racial disparities persist among US children and adults with the same sources of health insurance 16 , 17 , 18 , 19 , 20 and those treated by the same health systems.…”

Do depression, anxiety, emotional intelligence, and sleep quality affect diabetes management self-efficacy in Korean women with gestational diabetes in pregnancy?: a descriptive correlational study

“…Gestational diabetes mellitus (GDM) is diagnosed when glucose intolerance develops after 20 weeks of pregnancy in a woman who previously did not have diabetes [1]. According to a recent study, the incidence of GDM sharply increased by 30% in wom-en aged 15 to 44 years who had their first live birth between 2011 and 2019, and the highest rate of increase was noted among women of Asian descent [2]. GDM increases the risk of perinatal complications [1].…”

“…Therefore, we hypothesized that diabetes management self-efficacy was crucial for pregnant women with GDM to successfully practice diabetes management, and that various psychological, emotional, and physical factors could influence that self-efficacy. However, the existing literature has been focused on the changing trends in the treatment of pregnant women with GDM [2,3], the influence of self-efficacy on improved treatment compliance in this population [4], and the level of improvement in self-management or blood sugar control after interventions [10]. To the authors' knowledge, no studies have yet investigated the influence of the factors introduced above on the level of diabetes management self-efficacy.…”