Birth outcomes among American Indian/Alaska Native women with diabetes in pregnancy.
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.
LaVallie
Donna L
DL
Departments of Pediatrics and Family Medicine, University of Washington, Center for Health Studies, Group Health Cooperative/Permanente, Seattle, Washington, USA. d12@u.washington.edu
Gabbe
Steven G
SG
Grossman
David C
DC
Larson
Eric B
EB
Baldwin
Laura-Mae
LM
Andrilla
C Holly A
CH
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*