Risk of Adverse Pregnancy Outcomes Among Pregnant Individuals With Gestational Diabetes by Race & Ethnicity in the US

For a study, researchers sought to see if the frequency of unfavorable pregnancy outcomes increased over time among women with gestational diabetes in the United States, and if the risk of these varied events by maternal race and ethnicity. Exploratory serial, cross-sectional, descriptive analysis of 1,560,822 persons with gestational diabetes aged 15 to 44 years with singleton non-anomalous live deliveries in the United States from 2014 to 2020 using natality data from the National Center for Health Statistics. Year of birth and race and ethnicity, as indicated on the birth certificate, are classified as non-Hispanic American Indian, non-Hispanic Asian/Pacific Islander, non-Hispanic Black, Hispanic/Latina, and non-Hispanic White (reference group). Cesarean delivery, primary cesarean delivery, preeclampsia or gestational hypertension, intensive care unit (ICU) admission, and transfusion were among the maternal outcomes of interest; neonatal outcomes included large for gestational age (LGA), macrosomia (>4000 g at birth), small for gestational age (SGA), preterm birth, and neonatal ICU (NICU) admission, as measured by the frequency (per 1000 live births) with an estimation of

About 1% were American Indian, 13% were Asian/Pacific Islander, 12% were Black, 27% were Hispanic/Latina, and 48% were White of the 1,560,822 pregnant women with gestational diabetes (mean [SD] age, 31 [5.5] ). Preeclampsia or gestational hypertension (4.2%) [95% CI, 3.3% to 5.2%]), transfusion (8.0% [95% CI, 3.8% to 12.4%]), preterm birth at less than 37 weeks (0.9% [95% CI, 0.3% to 1.5%]), and NICU admission all increased statistically significantly from 2014 to 2020 (mean APC per year) (1.0% [95% CI, 0.3% to 1.7% ]). Cesarean delivery (1.4%) [95% CI, 1.7% to 1.1%]), primary cesarean delivery (1.2% [95% CI, 1.5% to 0.9%]), LGA (2.3% [95% CI, 2.8% to 1.8%]), and macrosomia (4.7% [95% CI, 5.3% to 4.0%]) all saw a significant decrease. In terms of maternal ICU hospitalization and SGA, there was no significant difference. In comparison to White people, Black people had a significantly higher risk of all outcomes except LGA and macrosomia; American Indian people had a significantly higher risk of all outcomes except cesarean delivery and SGA; and Hispanic/Latina and Asian/Pacific Islander people had a significantly higher risk of maternal ICU admission, preterm birth, NICU admission, and SGA. Throughout these years, disparities in poor outcomes by race and ethnicity remained.

From 2014 to 2020, the likelihood of several poor pregnancy outcomes rose among pregnant women with gestational diabetes in the United States. The disparities in poor outcomes by race and ethnicity remained.

Reference:jamanetwork.com/journals/jama/article-abstract/2790938

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