Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
BMJ Open Diabetes Res Care. 2022 Feb;10(1). doi: 10.1136/bmjdrc-2021-002329.
Gestational diabetes mellitus (GDM) is a common complication of pregnancy with implications for cardiovascular health. Among reproductive-aged women, less is known about nativity-related disparities in cardiometabolic risk profiles and GDM history. We examined how cardiometabolic risk profiles and GDM history differed by nativity and explored associations between acculturation, cardiometabolic risk profiles and GDM history.
We analyzed cross-sectional data from the 2016-2017 National Health Interview Survey among reproductive-aged women (18-49 years) who both reported ever being pregnant and answered the question on GDM history. Using multivariable logistic regression, we examined the percentage with GDM history and compared cardiometabolic profiles by nativity status and acculturation (duration of US residence).
Of 9525 women, 22.5% were foreign-born. Also, 11.7% of foreign-born women had a GDM history vs 9.6% of US-born women. Foreign-born women with ≥10 years US residence had the highest age-standardized percentage with GDM history (11.0%) compared with US-born women (9.2%) and foreign-born women with <10 years US residence (6.7%). US-born women had a higher prevalence of hypertension, current smoking, and alcohol use than foreign-born women. Among foreign-born women, those with ≥10 years US residence had a higher prevalence of hypertension, current smoking, and alcohol use than those with <10 years US residence. In the fully adjusted model, foreign-born women with ≥10 years US residence had higher odds of GDM history than US-born women (OR 1.43; 95% CI 1.17 to 1.76) while foreign-born women with <10 years US residence and US-born women has similar odds of GDM history.
Greater duration of US residence may be associated with nativity-related disparities in GDM. Acculturation, including changing health-related behaviors may explain the disparities among foreign-born women and should be further investigated to appropriately target interventions to prevent GDM and future cardiometabolic diseases.
妊娠糖尿病（GDM）是一种常见的妊娠并发症，对心血管健康有影响。在育龄妇女中，关于出生地相关的心血管代谢风险特征和 GDM 病史差异的了解较少。我们研究了心血管代谢风险特征和 GDM 病史如何因出生地而异，并探讨了文化适应与心血管代谢风险特征和 GDM 病史之间的关联。
我们分析了 2016-2017 年全国健康访谈调查中报告过怀孕且回答过 GDM 病史问题的育龄妇女（18-49 岁）的横断面数据。我们使用多变量逻辑回归，检查了 GDM 病史的百分比，并根据出生地和文化适应状况（在美国居住时间）比较了心血管代谢特征。
在 9525 名女性中，22.5%是外国出生的。此外，11.7%的外国出生女性有 GDM 病史，而 9.6%的美国出生女性有 GDM 病史。与美国出生的女性（9.2%）和在美国居住时间<10 年的外国出生的女性（6.7%）相比，在美国居住时间≥10 年的外国出生的女性有最高的年龄标准化 GDM 病史百分比（11.0%）。美国出生的女性比外国出生的女性更常见高血压、当前吸烟和饮酒。在外国出生的女性中，在美国居住时间≥10 年的女性比在美国居住时间<10 年的女性更常见高血压、当前吸烟和饮酒。在完全调整的模型中，在美国居住时间≥10 年的外国出生女性比美国出生女性更有可能有 GDM 病史（OR 1.43；95%CI 1.17-1.76），而在美国居住时间<10 年的外国出生女性和美国出生女性有相似的 GDM 病史几率。
在美国居住时间较长可能与 GDM 相关的出生地差异有关。文化适应，包括改变与健康相关的行为，可能解释了外国出生女性的差异，应进一步调查，以适当针对干预措施，预防 GDM 和未来的心血管代谢疾病。
