title: Socio-cultural disparities in GDM burden differ by maternal age at first delivery.
abstract: OBJECTIVE
  Several socio-cultural and biomedical risk factors for gestational diabetes mellitus (GDM) are modifiable. However, few studies globally have examined socio-cultural associations. To eliminate confounding of increased risk of diabetes in subsequent pregnancies, elucidating socio-cultural associations requires examination only of first pregnancies.
  
  
  METHODS
  Data for all women who delivered their first child in Victoria, Australia between 1999 and 2008 were extracted from the Victorian Perinatal Data Collection. Crude and adjusted GDM rates were calculated. Multivariate logistic regression was used to examine odds of GDM within and between socio-cultural groups.
  
  
  RESULTS
  From 1999 to 2008, 269,682 women delivered their first child in Victoria. GDM complicated 11,763 (4.4%) pregnancies and burden increased with maternal age, from 2.1% among women aged below 25 years at delivery to 7.0% among those aged 35 years or more. Among younger women, GDM rates were relatively stable across socioeconomic levels. Amongst older women GDM rates were highest in those living in most deprived areas, with a strong social gradient. Asian-born mothers had highest GDM rates. All migrant groups except women born in North-West Europe had higher odds of GDM than Australian-born non-Indigenous women. In all ethnic groups, these differences were not pronounced among younger mothers, but became increasingly apparent amongst older women.
  
  
  CONCLUSIONS
  Socio-cultural disparities in GDM burden differ by maternal age at first delivery. Socio-cultural gradients were not evident among younger women. Health and social programs should seek to reduce the risk amongst all older women to that of the least deprived older mothers.
authors: Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia.
authors: Marion
authors: M
authors: Abouzeid
authors: Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, Victoria, Australia.
authors: Vincent L
authors: VL
authors: Versace
authors: Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, Victoria, Australia; Department of Medicine, Northwest Academic Centre, The University of Melbourne and Western Health, Victoria, Australia.
authors: Edward D
authors: ED
authors: Janus
authors: Consultative Council on Obstetric and Paediatric Mortality and Morbidity, Clinical Councils Unit, Department of Health, Victoria, Australia; Mother and Child Health Research, La Trobe University, Victoria, Australia.
authors: Mary-Ann
authors: MA
authors: Davey
authors: Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, Victoria, Australia.
authors: Benjamin
authors: B
authors: Philpot
authors: Consultative Council on Obstetric and Paediatric Mortality and Morbidity, Clinical Councils Unit, Department of Health, Victoria, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
authors: Jeremy
authors: J
authors: Oats
authors: Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, Victoria, Australia.
authors: James A
authors: JA
authors: Dunbar
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000208:ethnology* / Q000503:physiopathology; D005260:Female; D020073:Gravidity; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D012923:Social Class; D014739:Victoria / Q000453:epidemiology