title: Impact of maternal diabetes on birthweight is greater in non-Hispanic blacks than in non-Hispanic whites.
abstract: OBJECTIVE
  To determine the impact of maternal diabetes during pregnancy on racial disparities in fetal growth.
  
  
  METHODS
  Using linked birth certificate, inpatient hospital and prenatal claims data we examined live singleton births of mothers resident in South Carolina who self-reported their race as non-Hispanic white (NHW; n = 140,128) or non-Hispanic black (NHB; n = 82,492) and delivered at 28-42 weeks' gestation between 2004 and 2008.
  
  
  RESULTS
  Prepregnancy diabetes prevalence was higher in NHB (3.0%) than in NHW (1.7%), while the prevalence of gestational diabetes mellitus (GDM) was similar in NHB (6.1%) and NHW (6.3%). At a delivery BMI of 35 kg/m(2), GDM exposure was associated with an average birthweight only 17 g (95% CI 4, 30) higher in NHW, but 78 g (95% CI 61, 95) higher in NHB (controlling for gestational age, maternal age, infant sex and availability of information on prenatal care). Figures for prepregnancy diabetes were 58 g (95% CI 34, 81) in NHW and 60 g (95% CI 37, 84) in NHB. GDM had a greater impact on birthweight in NHB than in NHW (60 g racial difference [95% CI 39, 82]), while prepregnancy diabetes had a large but similar impact. Similarly, the RR for GDM of having a large- relative to a normal-weight-for-gestational-age infant was lower in NHW (RR 1.41 [95% CI 1.34, 1.49]) than in NHB (RR 2.24 [95% CI 2.05, 2.46]).
  
  
  CONCLUSIONS
  These data suggest that the negative effects of GDM combined with obesity during pregnancy may be greater in NHB than in NHW individuals.
authors.affiliation: Department of Medicine/Biostatistics and Epidemiology, Medical University of South Carolina, Charleston, SC 29425, USA. huntke@musc.edu
authors.forename: K J
authors.initials: KJ
authors.lastname: Hunt
authors.forename: N M
authors.initials: NM
authors.lastname: Marlow
authors.forename: M
authors.initials: M
authors.lastname: Gebregziabher
authors.forename: C N
authors.initials: CN
authors.lastname: Ellerbe
authors.forename: J
authors.initials: J
authors.lastname: Mauldin
authors.forename: M E
authors.initials: ME
authors.lastname: Mayorga
authors.forename: J E
authors.initials: JE
authors.lastname: Korte
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D001724:Birth Weight / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D016640:Diabetes, Gestational / Q000208:ethnology*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D009765:Obesity / Q000208:ethnology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000208:ethnology*; D013022:South Carolina; D044465:White People