title: Birth outcomes among American Indian/Alaska Native women with diabetes in pregnancy.
abstract: OBJECTIVE
  To describe perinatal outcomes and maternal characteristics among American Indian/Alaska Native (AI/AN) women with diabetes in pregnancy.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Multiple maternal risk factors and birth outcomes demonstrate the need for further research to evaluate methods of improving care in this population.
authors.affiliation: Departments of Pediatrics and Family Medicine, University of Washington, Center for Health Studies, Group Health Cooperative/Permanente, Seattle, Washington, USA. d12@u.washington.edu
authors.forename: Donna L
authors.initials: DL
authors.lastname: LaVallie
authors.forename: Steven G
authors.initials: SG
authors.lastname: Gabbe
authors.forename: David C
authors.initials: DC
authors.lastname: Grossman
authors.forename: Eric B
authors.initials: EB
authors.lastname: Larson
authors.forename: Laura-Mae
authors.initials: LM
authors.lastname: Baldwin
authors.forename: C Holly A
authors.initials: CH
authors.lastname: Andrilla
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000413:Alaska / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000208:ethnology*; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008425:Maternal Behavior / Q000208:ethnology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D011295:Prenatal Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data*