Racial disparities in perinatal outcomes among women with gestational diabetes.
BACKGROUND
We sought to evaluate perinatal outcomes by race/ethnicity among women with gestational diabetes mellitus (GDM).


METHODS
We conducted a 14-year retrospective cohort study of women with GDM. Selected perinatal outcomes were examined. Unadjusted and adjusted prevalence ratios (PR, aPR) of perinatal outcomes, comparing Hispanic and African American women with Caucasian women, were calculated.


RESULTS
Hispanics comprised 54% of the 1018 woman cohort. Half received medical management of GDM (52%), more than African Americans (45%) or Caucasians (39%)(p<0.05). Compared with Caucasians, Hispanics had fewer deliveries <37 weeks (aPR 0.58, 95% confidence interval [CI] 0.42-0.81), less gestational hypertension (aPR 0.43, 95% CI 0.22-0.83), larger median birth weight infants (3453 g vs 3291 g, p<0.05), and greater risk of shoulder dystocia (aPR 3.52, 95% CI 1.30-9.50). Hispanic women had fewer adverse outcomes overall compared with Caucasian or African American women.


CONCLUSIONS
We report differences between Hispanic and Caucasian women with GDM. Treatment to achieve glycemic control and reduce adverse outcomes may differ by race/ethnicity.
Department of Obstetrics and Gynecology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, North Carolina, USA. erica.berggren@gmail.com
Erica K
EK
Berggren
Kim A
KA
Boggess
Michele Jonsson
MJ
Funk
Alison M
AM
Stuebe
D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D044466:Asian People; D001724:Birth Weight; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007333:Insulin Resistance / Q000208:ethnology; D009657:North Carolina / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology; D015995:Prevalence; D012189:Retrospective Studies; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data
D006442:Glycated Hemoglobin