The impact of socioeconomic deprivation on the prevalence of gestational diabetes: An observational study

Abstract

Approximately 3.5% of pregnancies in the United Kingdom are complicated by gestational diabetes mellitus (GDM). Risk factors for this mirror those contributing to type 2 diabetes (T2DM). Though socioeconomic status (SES) is presumed to contribute to GDM, evidence in the United Kingdom is limited. In this unique study, we explored the impact of SES on GDM prevalence in a London suburb population. Four thousand one hundred and sixty-three pregnant women who booked between July 2018 and March 2020 at Princess Royal University Hospital were retrospectively analyzed. Associations between GDM prevalence and SES trends (using multiple deprivation deciles (MDD)), and body mass index (BMI), age, ethnicity, screening uptake, birth-weights and birth outcomes, were analyzed. Patients with BMI >30 kg/m2, older than 35 years, and non-Caucasian ethnicity have an increased risk of developing GDM ( p < 0.0001, p < 0.0001, p < 0.0001, respectively). No association existed between MDD and GDM prevalence ( p-values over 0.05). Patients with risk factors for GDM were highest in the deprived areas p < 0.0001. MDD 1–4 (most deprived) had the highest percentage of missed screening (15% of patients with risk factors missed screening), compared to 8% in the least deprived group ( p < 0.0001). Our data surprisingly suggest that low SES did not increase the incidence of GDM, despite a higher proportion of women with risk factors for GDM living in the most deprived postcodes. However this unclear finding may be due to low screening uptake of deprived populations, and therefore lack of GDM diagnosis, or indicate that GDM is a result of a different aetiology to T2DM. Further research is needed to explore if access to screening services, lack of health education or other health inequalities were responsible for the high proportion of missed screening opportunities in deprived areas.