Title: Gestational diabetes in a multiethnic population of Spain: Clinical characteristics and perinatal outcomes
Abstract: Aims 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/m2 (76.4%, P = 0.012), while East Asian women had lower BMI (23.41 ± 2.79 kg/m2, 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 HAPO Study Cooperative Research Group Metzger B.E. Lowe L.P. Dyer A.R. Trimble E.R. Chaovarindr U. et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008; 358: 1991-2002 Crossref PubMed Scopus (3624) Google Scholar , 5 Crowther C.A. Hiller J.E. Moss J.R. McPhee A.J. Jeffries W.S. Robinson J.S. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005; 352: 2477-2486 Crossref PubMed Scopus (2337) Google Scholar , 6 Xiang A.H. Li B.H. Black M.H. Sacks D.A. Buchanan T.A. Jacobsen S.J. et al. Racial and ethnic disparities in diabetes risk after gestational diabetes mellitus. Diabetologia. 2011; 54: 3016-3021 Crossref PubMed Scopus (104) Google Scholar , 7 Hedderson M.M. Darbinian J.A. Ferrara A. Disparities in the risk of gestational diabetes by race-ethnicity and country of birth. Paediatr Perinat Epidemiol. 2010; 24: 441-450 Crossref PubMed Scopus (128) Google Scholar , 8 Savitz D.A. Janevic T.M. Engel S.M. Kaufman J.S. Herring A.H. Ethnicity and gestational diabetes in New York City, 1995–2003. BJOG. 2008; 115: 969-978 Crossref PubMed Scopus (141) Google Scholar , 9 Hunsberger M. Rosenberg K.D. Donatelle R.J. Racial/ethnic disparities in gestational diabetes mellitus: findings from a population-based survey. Womens Health Issues. 2010; 20: 323-328 Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar , 10 Kim C. Berger D.K. Chamany S. Recurrence of gestational diabetes mellitus. Diabetes Care. 2007; 30: 1314-1319 Crossref PubMed Scopus (218) Google Scholar ], 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.
Publication Year: 2013
Publication Date: 2013-03-26
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 28
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