title: The effect of race/ethnicity on adverse perinatal outcomes among patients with gestational diabetes mellitus.
abstract: OBJECTIVE
  The purpose of this study was to determine racial/ethnic differences in perinatal outcomes among women with gestational diabetes mellitus.
  
  
  METHODS
  We conducted a retrospective cohort study of 32,193 singleton births among women with gestational diabetes mellitus in California from 2006, using Vital Statistics Birth and Death Certificate and Patient Discharge Data. Data were divided by race/ethnicity: white, black, Hispanic, or Asian. Multivariable logistic regression was used to analyze associations between race/ethnicity and adverse outcomes that were controlled for potential confounders. Outcomes included primary cesarean delivery, preeclampsia, neonatal hypoglycemia, preterm delivery, macrosomia, fetal anomaly, and respiratory distress syndrome.
  
  
  RESULTS
  Compared with women in other races, black women had higher odds of preeclampsia (adjusted odds ratio [aOR], 1.57; 95% confidence interval [CI], 1.47-1.95), neonatal hypoglycemia (aOR, 1.79; 95% CI, 1.07-3.00), and preterm delivery <37 weeks' gestation (aOR, 1.56; 95% CI, 1.33-1.83). Asian women had the lowest odds of primary cesarean delivery (aOR, 0.75; 95% CI, 0.69-0.82), large-for-gestational-age infants (aOR, 0.40; 95% CI, 0.33-0.48), and neonatal respiratory distress syndrome (aOR, 0.54; 95% CI, 0.40-0.73).
  
  
  CONCLUSIONS
  Perinatal outcomes among women with gestational diabetes mellitus differ by race/ethnicity and may be attributed to inherent sociocultural differences that may impact glycemic control, the development of chronic comorbidities, genetic variability, and variation in access to prenatal care, and quantity and quality of prenatal care.
authors: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR 97239, USA. nguyebri@ohsu.edu
authors: Brian T
authors: BT
authors: Nguyen
authors: Yvonne W
authors: YW
authors: Cheng
authors: Jonathan M
authors: JM
authors: Snowden
authors: Tania F
authors: TF
authors: Esakoff
authors: Antonio E
authors: AE
authors: Frias
authors: Aaron B
authors: AB
authors: Caughey
mesh_terms: D000328:Adult; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D016640:Diabetes, Gestational / Q000208:ethnology*; D005006:Ethnicity; D005260:Female; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011225:Pre-Eclampsia / Q000208:ethnology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D012189:Retrospective Studies