Erbetta Kristin, Almeida Joanna, Waldman Marcus R
Simmons University, 300 the Fenway, Boston, MA, 02115, USA.
University of Nebraska Medical Center, 42nd and Emile, Omaha, NE, 68198, USA.
SSM Popul Health. 2022 Jul 21;19:101176. doi: 10.1016/j.ssmph.2022.101176. eCollection 2022 Sep.
Racial/ethnic minority and foreign-born women in the United States are at high risk of experiencing racial discrimination, which is associated with adverse health outcomes. Although racial discrimination is associated with metabolic disturbances such as insulin resistance and type 2 diabetes, more studies should examine its effect on gestational diabetes mellitus (GDM), which is highest among racial/ethnic minority and foreign-born women.
We used New York City Pregnancy Risk and Assessment Monitoring System survey data (2012-2014) linked with birth certificate items (N = 4084) in bivariate and multivariate analyses to examine racial/ethnic/nativity differences in racial discrimination, and to test if racial discrimination explains racial/ethnic/nativity inequalities in GDM
The 12-month prevalence of racial discrimination (9.5%) varied across race/ethnicity and nativity status, with Black, Hispanic and foreign-born women having the highest prevalence. Interaction effects indicate that US-born Black and Hispanic women are at increased risk of racial discrimination compared to their foreign-born counterparts. Women with GDM had statistically higher prevalence of racial discrimination (14%) compared with women without GDM (9%). Racial discrimination was associated with a 57% increased unadjusted risk of GDM (RR = 1.57, 95% CI [1.19, 2.06]) that decreased to 24% after adjusting for all covariates (RR = 1.24, 95% CI [0.87, 1.78]).
The high proportion of racial/ethnic minority and foreign-born women experiencing racial discrimination, and its potential impact on GDM, underscores the importance of culturally informed screening and intervention approaches by trained professionals.
美国的少数族裔和外国出生女性遭受种族歧视的风险很高，这与不良健康结果相关。虽然种族歧视与胰岛素抵抗和2型糖尿病等代谢紊乱有关，但更多研究应考察其对妊娠糖尿病（GDM）的影响，妊娠糖尿病在少数族裔和外国出生女性中最为常见。
我们使用纽约市妊娠风险与评估监测系统的调查数据（2012 - 2014年），并将其与出生证明项目相关联（N = 4084），进行双变量和多变量分析，以研究种族歧视在种族/族裔/出生地方面的差异，并检验种族歧视是否能解释GDM在种族/族裔/出生地方面的不平等现象。
种族歧视的12个月患病率（9.5%）因种族/族裔和出生地状况而异，黑人、西班牙裔和外国出生女性的患病率最高。交互作用表明，与外国出生的同行相比，美国出生的黑人和西班牙裔女性遭受种族歧视的风险更高。患有GDM的女性种族歧视患病率（14%）在统计学上高于未患GDM的女性（9%）。种族歧视与未经调整的GDM风险增加57%相关（RR = 1.57，95% CI [1.19, 2.06]），在对所有协变量进行调整后，该风险降至24%（RR = 1.24，95% CI [0.87, 1.78]）。
少数族裔和外国出生女性中遭受种族歧视的比例很高，以及其对GDM的潜在影响，凸显了由训练有素的专业人员采用具有文化针对性的筛查和干预方法的重要性。
