title: The association between body mass index and gestational diabetes mellitus varies by race/ethnicity.
abstract: We examined body mass index (BMI) as a screening tool for gestational diabetes (GDM) and its sensitivity among different racial/ethnic groups. In a retrospective cohort study of 24,324 pregnant women at University of California, San Francisco, BMI was explored as a screening tool for GDM and was stratified by race/ethnicity. Sensitivity and specificity were examined using chi-square test and receiver-operator characteristic curves. BMI of ≥25.0 kg/m (2) as a screening threshold identified GDM in >76% of African-Americans, 58% of Latinas, and 46% of Caucasians, but only 25% of Asians ( P < 0.001). Controlling for confounders and comparing to a BMI of ≤25, African-Americans had the greatest increased risk of GDM (adjusted odds ratio [AOR] 5.1, 95% confidence interval [CI]: 3.0 to 8.5), followed by Caucasians (AOR 3.6, 95% CI: 2.7 to 4.8), Latinas (AOR 2.7, 95% CI: 1.9 to 3.8), and Asians (AOR 2.3, 95% CI: 1.8 to 3.0). BMI's screening characteristics to predict GDM varied by race/ethnicity. BMI can be used to counsel regarding the risk of developing GDM, but alone it is not a good screening tool.
authors.affiliation: Department of Obstetrics and Gynecology, University of California-Los Angeles, CA, USA. .
authors.forename: Amy
authors.initials: A
authors.lastname: Shah
authors.forename: Naomi E
authors.initials: NE
authors.lastname: Stotland
authors.forename: Yvonne W
authors.initials: YW
authors.lastname: Cheng
authors.forename: Gladys A
authors.initials: GA
authors.lastname: Ramos
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Caughey
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001213:Asian / Q000706:statistics & numerical data; D015992:Body Mass Index; D002140:California / Q000453:epidemiology; D016009:Chi-Square Distribution; D016640:Diabetes, Gestational / Q000208:ethnology*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015999:Multivariate Analysis; D011247:Pregnancy; D012372:ROC Curve; D012189:Retrospective Studies; D044465:White People / Q000706:statistics & numerical data