title: Gestational diabetes in a multiethnic population of Spain: clinical characteristics and perinatal outcomes.
abstract: OBJECTIVE
  To compare clinical characteristics and perinatal outcomes between immigrant and Spanish women with gestational diabetes mellitus (GDM) in a multiethnic population of Barcelona and to identify factors independently associated with the development of large-for-gestational-age (LGA) infants.
  
  
  METHODS
  Prospective study of women with GDM from five ethnic groups (Caucasian, South-Central Asian, Latin American, East Asian and Moroccan) at a single institution in Barcelona between 2004 and 2011. Maternal, gestational and newborn characteristics were recorded.
  
  
  RESULTS
  The cohort included 456 patients. In univariate analyses, Moroccan women had more frequently a pre-gestational body mass index (BMI)>25 kg/m(2) (76.4%, P=0.012), while East Asian women had lower BMI (23.41 ± 2.79 kg/m(2), P<0.001), less need for insulin therapy (14.3%, P=0.013) and the highest rate of spontaneous labor (69.8%, P=0.014) and eutocic delivery (63.8%, P=0.032). Also, Latin American women had a higher rate of Cesarean section (52.9%, P<0.001) and LGA infants (28.6%, P=0.004), and their newborns had lower umbilical cord pH (7.23 ± 0.06, P=0.005) and Apgar scores (9 [4-10], P<0.01) and a higher incidence of neonatal hypoglycemia (51.4%, P=0.045). Logistic regression analysis identified pre-gestational BMI (OR: 1.18; 95% CI: 1.09-1.27), pregnancy weight gain (OR: 1.19; 95% CI: 1.1-1.28) and insulin use during gestation (OR: 2.29; 95% CI: 1.09-4.82) as predictors of LGA infants.
  
  
  CONCLUSIONS
  Significant ethnic differences were found in clinical characteristics and perinatal outcomes of women with GDM. Latin American women had a higher frequency of adverse perinatal outcomes. Pregestational BMI, pregnancy weight gain and insulin use during pregnancy were independent predictors of LGA.
authors.affiliation: Department of Endocrinology, Parc de Salut Mar, Barcelona, Spain.
authors.forename: Elisa
authors.initials: E
authors.lastname: Hernandez-Rivas
authors.forename: Juana A
authors.initials: JA
authors.lastname: Flores-Le Roux
authors.forename: David
authors.initials: D
authors.lastname: Benaiges
authors.forename: Enric
authors.initials: E
authors.lastname: Sagarra
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Chillaron
authors.forename: Antoni
authors.initials: A
authors.lastname: Paya
authors.forename: Jaume
authors.initials: J
authors.lastname: Puig-de Dou
authors.forename: Albert
authors.initials: A
authors.lastname: Goday
authors.forename: Maria A
authors.initials: MA
authors.lastname: Lopez-Vilchez
authors.forename: Juan
authors.initials: J
authors.lastname: Pedro-Botet
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology