Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
J Womens Health (Larchmt). 2022 Dec;31(12):1791-1799. doi: 10.1089/jwh.2022.0017. Epub 2022 Aug 30.
Hispanic women are disproportionately affected by gestational diabetes mellitus (GDM), yet few studies have assessed the impact of acculturation on health behaviors that may reduce GDM risk. We assessed relationships between acculturation and meeting American Diabetes Association guidelines for macronutrient intake and American College of Obstetricians and Gynecologists guidelines for physical activity (PA) using baseline data from Estudio Project Aiming to Reduce Type twO diabetes, a randomized trial conducted in Massachusetts (2013-2017) among 255 Hispanic pregnant women with hyperglycemia. Acculturation was assessed the Psychological Acculturation Scale, duration of time and generation in the continental United States, and language preference; diet with 24-hours dietary recalls; and PA with the Pregnancy Physical Activity Questionnaire (PPAQ). The majority of participants who reported low psychological acculturation (74.9%), preferred English (78.4%), were continental U.S. born (58.0%), and lived in the continental United States ≥5 years (91.4%). A total of 44.8%, 81.8%, 22.9%, and 4.6% of women met guidelines for carbohydrate, protein, fat, and fiber intakes, respectively; 31.9% met guidelines for PA. Women with higher acculturation were less likely to meet carbohydrate guidelines (English preference: adjusted risk ratios [aRR] 0.45, 95% confidence intervals [CI] 0.23-0.75; U.S. born: aRR 0.60, 95% CI 0.36-0.91; duration of time in United States: aRR 0.96, 95% CI 0.92-0.99). Women with higher acculturation were more likely to meet PA guidelines (U.S. born: aRR 1.95, 95% CI 1.11-3.44). In summary, higher acculturation was associated with lower likelihood of meeting dietary guidelines but greater likelihood of meeting PA guidelines during pregnancy. Interventions aimed at reducing GDM in Hispanics should be culturally informed and incorporate acculturation. Clinical Trial Registration: clinicaltrials.gov NCT01679210.
西班牙裔女性受到妊娠糖尿病（GDM）的影响不成比例，但很少有研究评估文化适应对可能降低 GDM 风险的健康行为的影响。我们使用在马萨诸塞州进行的旨在减少 2 型糖尿病的项目研究（2013-2017 年）中的基线数据，评估了文化适应与符合美国糖尿病协会宏量营养素摄入指南和美国妇产科医师学会身体活动（PA）指南之间的关系，该研究纳入了 255 名患有高血糖的西班牙裔孕妇，采用心理文化适应量表、在美国大陆的时间和代际以及语言偏好来评估文化适应；通过 24 小时膳食回忆评估饮食；通过妊娠体力活动问卷（PPAQ）评估 PA。大多数报告低心理文化适应的参与者（74.9%）、更喜欢英语（78.4%）、出生于美国大陆（58.0%）并且在美国大陆居住时间≥5 年（91.4%）。分别有 44.8%、81.8%、22.9%和 4.6%的女性符合碳水化合物、蛋白质、脂肪和纤维摄入量指南；31.9%符合 PA 指南。文化适应程度较高的女性更不可能符合碳水化合物摄入量指南（英语偏好：调整后的风险比[aRR]0.45，95%置信区间[CI]0.23-0.75；美国出生：aRR0.60，95%CI0.36-0.91；在美国的时间：aRR0.96，95%CI0.92-0.99）。文化适应程度较高的女性更有可能符合 PA 指南（美国出生：aRR1.95，95%CI1.11-3.44）。总之，文化适应程度较高与妊娠期间更不可能符合饮食指南但更有可能符合 PA 指南有关。针对西班牙裔人群降低 GDM 的干预措施应该具有文化意识并结合文化适应。临床试验注册：clinicaltrials.gov NCT01679210。
