Esakoff Tania F, Caughey Aaron B, Block-Kurbisch Ingrid, Inturrisi Maribeth, Cheng Yvonne W
Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
J Matern Fetal Neonatal Med. 2011 Mar;24(3):422-6. doi: 10.3109/14767058.2010.504287. Epub 2010 Jul 20.
To determine if racial/ethnic differences exist in perinatal outcomes in women with gestational diabetes mellitus (GDM).
This is a retrospective cohort study of singleton pregnancies with GDM cared for by the Sweet Success: California Diabetes and Pregnancy Program (CDAPP) between 2001 and 2004 at inpatient obstetric and neonatal services in California. There were a total of 26,411 women with gestational diabetes who were subgrouped by four races/ethnicities: Caucasian, African-American, Latina, and Asian. The chi-squared test was used to compare the dichotomous outcomes and p<0.05 was used to indicate statistical significance. Multivariable logistic regression analyses were performed to control for potential confounders. Perinatal outcomes, including severity of GDM, cesarean delivery (CD), birthweight, preterm birth, intrauterine fetal demise (IUFD) and neonatal intensive care unit (NICU) admission were compared.
Compared to Caucasians, African-Americans had higher odds of primary CD [aOR=1.29, 95% CI (1.05?1.59)] while lower odds were seen in Latinas [aOR=0.84, 95% CI (0.75-0.94)] and Asians [aOR=0.86, 95% CI (0.77-0.96)]. Asians had lower odds [aOR=0.58 (95% CI 0.48-0.70)] of birthweight >4000 g. African-Americans had highest odds of IUFD [aOR=5.93 95% CI (1.73-20.29)]. There were no differences in NICU admission.
Perinatal outcomes in women diagnosed with GDM differ by racial/ethnic group. Such variation can be used to individually counsel women with GDM.
确定患有妊娠期糖尿病（GDM）的女性围产期结局是否存在种族/民族差异。
这是一项回顾性队列研究，研究对象为2001年至2004年在加利福尼亚州住院产科和新生儿服务机构接受“甜蜜成功：加利福尼亚糖尿病与妊娠项目”（CDAPP）护理的患有GDM的单胎妊娠。共有26411名患有妊娠期糖尿病的女性，按四个种族/民族进行分组：白种人、非裔美国人、拉丁裔和亚裔。采用卡方检验比较二分结局，p<0.05表示具有统计学意义。进行多变量逻辑回归分析以控制潜在混杂因素。比较围产期结局，包括GDM严重程度、剖宫产（CD）、出生体重、早产、宫内胎儿死亡（IUFD）和新生儿重症监护病房（NICU）入院情况。
与白种人相比，非裔美国人进行初次剖宫产的几率更高[aOR=1.29，95%可信区间（1.05 - 1.59）]，而拉丁裔[aOR=0.84，95%可信区间（0.75 - 0.94）]和亚裔[aOR=0.86，95%可信区间（0.77 - 0.96）]的几率较低。亚裔出生体重>4000 g的几率较低[aOR=0.58（95%可信区间0.48 - 0.70）]。非裔美国人IUFD的几率最高[aOR=5.93，95%可信区间（1.73 - 20.29）]。NICU入院情况无差异。
被诊断患有GDM的女性围产期结局因种族/民族群体而异。这种差异可用于为患有GDM的女性提供个性化咨询。
