Cavicchia Philip P, Liu Jihong, Adams Swann A, Steck Susan E, Hussey James R, Daguisé Virginie G, Hebert James R
South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA,
Matern Child Health J. 2014 Oct;18(8):1919-26. doi: 10.1007/s10995-014-1437-8.
Objective was to estimate race-specific proportions of gestational diabetes mellitus (GDM) attributable to overweight and obesity in South Carolina. South Carolina birth certificate and hospital discharge data were obtained from 2004 to 2006. Women who did not have type 2 diabetes mellitus before pregnancy were classified with GDM if a diagnosis was reported in at least one data source. Relative risks (RR) and 95 % confidence intervals were calculated using the log-binomial model. The modified Mokdad equation was used to calculate population attributable fractions for overweight body mass index (BMI: 25.0-29.9 kg/m(2)), obese (30.0-34.9 kg/m(2)), and extremely obese (≥35 kg/m(2)) women after adjusting for age, gestational weight gain, education, marital status, parity, tobacco use, pre-pregnancy hypertension, and pregnancy hypertension. Overall, the adjusted RR of GDM was 1.6, 2.3, and 2.9 times higher among the overweight, obese, and extremely obese women compared to normal-weight women in South Carolina. RR of GDM for extremely obese women was higher among White (3.1) and Hispanic (3.4) women than that for Black women (2.6). The fraction of GDM cases attributable to extreme obesity was 14.0 % among White, 18.1 % among Black, and 9.6 % among Hispanic women. The fraction of GDM cases attributable to obesity was about 12 % for all racial groups. Being overweight (BMI: 25.0-29.9) explained 8.8, 7.8, and 14.4 % of GDM cases among White, Black, and Hispanic women, respectively. Results indicate a significantly increased risk of GDM among overweight, obese, and extremely obese women. The strength of the association and the proportion of GDM cases explained by excessive weight categories vary by racial/ethnic group.
目的是估算南卡罗来纳州因超重和肥胖导致的特定种族妊娠糖尿病（GDM）比例。获取了2004年至2006年南卡罗来纳州的出生证明和医院出院数据。孕前无2型糖尿病的女性，若至少在一个数据源中有GDM诊断记录，则被归类为GDM患者。使用对数二项式模型计算相对风险（RR）和95%置信区间。在对年龄、孕期体重增加、教育程度、婚姻状况、产次、吸烟情况、孕前高血压和孕期高血压进行校正后，采用改良的莫克德方程计算超重（体重指数BMI：25.0 - 29.9 kg/m²）、肥胖（30.0 - 34.9 kg/m²）和极度肥胖（≥35 kg/m²）女性的人群归因分数。总体而言，在南卡罗来纳州，超重、肥胖和极度肥胖女性的GDM校正RR分别比正常体重女性高1.6倍、2.3倍和2.9倍。极度肥胖女性的GDM RR在白人（3.1）和西班牙裔（3.4）女性中高于黑人女性（2.6）。白人女性中因极度肥胖导致的GDM病例比例为14.0%，黑人女性中为18.1%，西班牙裔女性中为9.6%。所有种族群体中因肥胖导致的GDM病例比例约为12%。超重（BMI：25.0 - 29.9）分别解释了白人、黑人和西班牙裔女性中8.8%、7.8%和14.4%的GDM病例。结果表明，超重、肥胖和极度肥胖女性患GDM的风险显著增加。关联强度以及由超重类别所解释的GDM病例比例因种族/族裔群体而异。
