Austin B Gardner, Macie L Champion, Teresa Janevic, Lynn M Yee, Ashley N Battarbee
{"title":"Psychosocial, Behavioral, and Medical Drivers of Gestational Diabetes among Racial-Ethnic Groups.","authors":"Austin B Gardner, Macie L Champion, Teresa Janevic, Lynn M Yee, Ashley N Battarbee","doi":"10.1055/a-2554-0925","DOIUrl":null,"url":null,"abstract":"<p><p>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.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.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 (<i>p</i> < 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 <i>p</i>-values > 0.1).Replacing race/ethnicity as a risk factor for GDM with significant upstream psychosocial, behavioral, and medical factors should be considered. · 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..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of perinatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2554-0925","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
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.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.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).Replacing race/ethnicity as a risk factor for GDM with significant upstream psychosocial, behavioral, and medical factors should be considered. · 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..
期刊介绍:
The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields.
The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field.
All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication.
The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.