Ethnic differences in perinatal outcome of gestational diabetes mellitus.
OBJECTIVE
Despite the high rates of gestational diabetes mellitus (GDM) among certain Pacific Islander and Asian ethnic groups in the U.S., little is known about the risk for adverse perinatal outcomes in these populations. We sought to examine ethnic differences in perinatal outcome among Asian and Pacific-Islander women with GDM.


METHODS
A retrospective review of all women referred to the largest outpatient GDM program in the state of Hawai'i from 1995 to 2005 was conducted. Patients of Native-Hawaiian/Pacific-Islander, Japanese, Chinese, Filipino, and Caucasian ethnicity were included (n = 2,155). Treatment of all patients consisted of an outpatient education class, dietary management, self-monitoring of blood glucose, and insulin instruction (if indicated). Demographics, maternal and neonatal characteristics, and delivery information were evaluated.


RESULTS
Neonates born to Native-Hawaiian/Pacific-Islander mothers and Filipino mothers had 4 and 2 times the prevalence of macrosomia, respectively, compared with neonates born to Japanese, Chinese, and Caucasian mothers. These differences persisted after adjustment for other statistically significant maternal and fetal characteristics. Ethnic differences were not observed for other neonatal or maternal complications associated with GDM, with the exception of neonatal hypoglycemia and hyperbilirubinemia.


CONCLUSIONS
Significant ethnic differences in perinatal outcomes exist across Asian and Pacific-Islander women with GDM. This finding emphasizes the need to better understand ethnic-specific factors in GDM management and the importance of developing ethnic-tailored GDM interventions to address these disparities.
Silva
Jana Kaida
JK
Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i, 677 Ala Moana Blvd., Suite 1016B, Honolulu, HI 96813, USA. jksilva@hawaii.edu
Kaholokula
Joseph Keawe'aimoku
JK
Ratner
Robert
R
Mau
Marjorie
M
D000328:Adult; D001213:Asian / Q000706:statistics & numerical data*; D001724:Birth Weight; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring / Q000379:methods; D016640:Diabetes, Gestational / Q000097:blood / Q000208:ethnology*; D005260:Female; D005320:Fetal Macrosomia / Q000208:ethnology; D005865:Gestational Age; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000097:blood / Q000208:ethnology; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D012189:Retrospective Studies
D001786:Blood Glucose