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Am J Perinatol
DOI: 10.1055/a-2554-0925
Original Article

Psychosocial, Behavioral, and Medical Drivers of Gestational Diabetes among Racial-Ethnic Groups

Austin B. Gardner
1   Department of OBGYN, University of Alabama at Birmingham, Birmingham, Alabama
2   Division of Reproductive Endocrinology and Infertility, Department of OBGYN, University of Pennsylvania, Philadelphia, Pennsylvania
,
Macie L. Champion 
3   Division of Maternal-Fetal Medicine, Department of OBGYN, University of Alabama at Birmingham, Birmingham, Alabama
,
Teresa Janevic
4   Department of Epidemiology, Columbia University Mailman School of Public Health, New York City, New York
,
Lynn M. Yee
5   Division of Maternal-Fetal Medicine, Department of OBGYN, Northwestern University Feinberg School of Medicine, Chicago, Illinois
,
Ashley N. Battarbee
3   Division of Maternal-Fetal Medicine, Department of OBGYN, University of Alabama at Birmingham, Birmingham, Alabama
› Institutsangaben
Funding None.
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Abstract

Objective

Certain racial and ethnic groups have historically been labeled “high-risk” for the development of gestational diabetes mellitus (GDM). Our objective was to identify the psychosocial, behavioral, and medical factors associated with GDM and determine if they differ by race/ethnicity.

Study Design

Secondary analysis of a multicenter, prospective cohort study of pregnant nulliparous individuals with singleton gestations (2010–2013). The primary outcome was GDM. Psychosocial, behavioral, and medical characteristics were compared by self-reported race/ethnicity. Multivariable logistic regression with backward selection identified factors associated with GDM. Interaction terms between race/ethnicity and risk factors were tested.

Results

Of 8,672 pregnant individuals, 61% were non-Hispanic White, 13% non-Hispanic Black, 17% Hispanic, 4% Asian, and 5% other. The incidence of GDM differed by race/ethnicity with 4% non-Hispanic White, 3% non-Hispanic Black, 5% Hispanic, 11% Asian, and 5% other (p < 0.001). Of 34 psychosocial, behavioral, and medical factors, those associated with GDM were parent with history of diabetes (adjusted odds ratio [aOR]: 1.72; 95% confidence interval [CI]: 1.33–2.23), non-English language (aOR: 2.57; 95% CI: 1.14–5.79), daily calorie intake (aOR: 1.18; 95% CI: 1.08–1.29), daily fiber intake (aOR: 0.84; 95% CI: 0.75–0.94), maternal age (aOR: 1.53; 95% CI: 1.37–1.70), prepregnancy BMI (aOR: 1.21; 95% CI: 1.02–1.44), and waist circumference (aOR: 1.21; 95% CI: 1.03–1.43). These associations did not differ based on race/ethnicity (interaction p-values > 0.1).

Conclusion

Replacing race/ethnicity as a risk factor for GDM with significant upstream psychosocial, behavioral, and medical factors should be considered.

Key Points

  • GDM varies in incidence based on race.

  • GDM was linked to a parent with various factors.

  • These factors are the history of diabetes, non-English language, and daily calorie intake.

  • These factors also include lower daily fiber intake, maternal age, prepregnancy BMI, and waist circumference.

  • The psychosocial, behavioral, and medical factors associated with GDM did not differ based on race/ethnicity.

Keywords

race - ethnicity - gestational diabetes mellitus - psychosocial - behavioral


Publikationsverlauf

Eingereicht: 17. Januar 2025

Angenommen: 10. März 2025

Artikel online veröffentlicht:
29. März 2025

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