Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA.
Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA.
J Matern Fetal Neonatal Med. 2020 Sep;33(17):2961-2969. doi: 10.1080/14767058.2019.1566310. Epub 2019 Jan 22.
To investigate the relationship between maternal race/ethnicity, maternal age at delivery, and the risk of gestational diabetes mellitus (GDM). Patients of Henry Ford Health System who delivered a live singleton child and were diagnosed with or without GDM in 2010-2015 were included. Maternal race/ethnicity, age, body mass index (BMI), parity, GDM in previous pregnancy, smoking status, and insurance membership were collected from the electronic health records. Neighborhood median family income data were obtained from US Census Bureau. Logistic regression analysis was performed to explore the effects of maternal race/ethnicity and age at delivery on the GDM outcome after adjusting for covariates including maternal BMI, parity, previous GDM, smoking status, and neighborhood family income. There were 16,258 women included in the study. Of those, 1801 women (12.5%) were diagnosed with GDM. Delivery at older ages (≥23 years) was associated with a significantly higher risk of a GDM diagnosis than younger ages [<23 years, OR (95% CI) = 2.24 (1.84, 2.73)-5.02 (4.18, 6.03)], however, the risk was not as profound in African American women (OR = 1.65) compared to non-African American women (OR = 2.07). In a multivariable model controlling for age, BMI, parity, previous GDM, smoking status, and the neighborhood family income, the risks of a GDM diagnosis were significantly higher in Asians [OR (95% CI) = 2.81 (2.28, 3.48)], Hispanics [OR (95% CI) = 1.27 (1.05, 1.55)], and Arab Americans [OR (95% CI) = 1.46 (1.20, 1.78)] and lower in African Americans [OR (95% CI) = 0.64 (0.56, 0.74)] as compared to whites. Asians, Hispanics, and Arab Americans have higher risk and African Americans have lower risk of a GDM diagnosis compared to whites. Delivery at an older maternal age increases the risk of GDM diagnosis. Race/ethnicity moderates the association between older maternal age and risk of GDM diagnosis. This study provides information for public health professionals, health practitioners, and pregnant women to be aware of and better understand the risk of GDM as related to race/ethnicity and maternal age.
为了研究孕产妇种族/民族、分娩年龄与妊娠糖尿病（GDM）风险之间的关系。本研究纳入了 2010 年至 2015 年间在亨利福特健康系统分娩且单胎活产的患者，并对其进行了 GDM 诊断或未诊断。从电子健康记录中收集了孕产妇种族/民族、年龄、体重指数（BMI）、产次、既往妊娠 GDM、吸烟状况和保险情况。从美国人口普查局获取了社区家庭收入中位数数据。通过多变量逻辑回归分析，在调整了包括母亲 BMI、产次、既往 GDM、吸烟状况和社区家庭收入等混杂因素后，探讨了孕产妇种族/民族和分娩年龄对 GDM 结局的影响。本研究共纳入了 16258 名女性，其中 1801 名女性（12.5%）被诊断为 GDM。与年轻产妇（<23 岁）相比，年龄较大（≥23 岁）分娩的女性 GDM 诊断风险显著升高[<23 岁，比值比（95%可信区间）=2.24（1.84，2.73）-5.02（4.18，6.03）]，但在非裔美国女性（比值比=1.65）中，这一风险不如在非非裔美国女性（比值比=2.07）中显著。在控制年龄、BMI、产次、既往 GDM、吸烟状况和社区家庭收入的多变量模型中，亚洲人（比值比（95%可信区间）=2.81（2.28，3.48））、西班牙裔（比值比（95%可信区间）=1.27（1.05，1.55））和阿拉伯裔美国人（比值比（95%可信区间）=1.46（1.20，1.78））的 GDM 诊断风险显著较高，而非裔美国人（比值比（95%可信区间）=0.64（0.56，0.74））的 GDM 诊断风险显著较低。与白人相比，亚洲人、西班牙裔和阿拉伯裔美国人的 GDM 诊断风险更高，而非裔美国人的 GDM 诊断风险更低。产妇年龄较大与 GDM 诊断风险增加有关。种族/民族调节了产妇年龄与 GDM 诊断风险之间的关联。本研究为公共卫生专业人员、卫生从业人员和孕妇提供了信息，以提高对种族/民族和产妇年龄与 GDM 风险之间关系的认识和理解。
