Research Department, Southcentral Foundation, 4501 Diplomacy Drive, 99508, Anchorage, AK, USA.
Center for Human Development, University of Alaska Anchorage, 3211 Providence Drive, 99508, 99504, Anchorage, AK, USA.
Matern Child Health J. 2022 Dec;26(12):2454-2465. doi: 10.1007/s10995-022-03536-w. Epub 2022 Nov 8.
To examine the relationships between pre-pregnancy diabetes mellitus (DM), gestational diabetes mellitus (GDM), pre-pregnancy body mass index (BMI) and county-level social determinants of health, with infant macrosomia within a sample of American Indian/Alaska Native (AI/AN) women receiving Indian Health Service (IHS) care.
The sample included women-infant dyads representing 1,136 singleton births from fiscal year 2011 (10/1/2019-9/30/2011). Data stemmed from the IHS Improving Health Care Delivery Data Project. Multivariate generalized linear mixed models were fitted to assess the association of macrosomia with pre-pregnancy health status and social determinants of health.
Nearly half of the women in the sample were under age 25 years (48.6%), and most had Medicaid health insurance coverage (76.7%). Of those with a pre-pregnancy BMI measure, 66.2% were overweight or obese. Although few women had pre-pregnancy DM (4.0%), GDM was present in 12.8% of women. Most women had a normal term delivery (85.4%). Overweight, obesity, pre-pregnancy DM, and county-level rurality were all significantly associated with higher odds of infant macrosomia.
在美国印第安人/阿拉斯加原住民（AI/AN）接受印第安人健康服务（IHS）护理的妇女样本中，研究孕前糖尿病（DM）、妊娠期糖尿病（GDM）、孕前体重指数（BMI）与县级社会决定因素与婴儿巨大儿之间的关系。
该样本包括来自 2011 财年（2019 年 10 月 1 日-2011 年 9 月 30 日）的 1,136 例单胎分娩的母婴对。数据源自 IHS 改善医疗服务交付数据项目。使用多变量广义线性混合模型评估巨大儿与孕前健康状况和社会决定因素的关系。
样本中近一半的妇女年龄在 25 岁以下（48.6%），大多数人拥有医疗补助健康保险（76.7%）。在有孕前 BMI 测量值的人群中，66.2%超重或肥胖。尽管很少有妇女患有孕前糖尿病（4.0%），但 12.8%的妇女患有妊娠期糖尿病。大多数妇女足月分娩（85.4%）。超重、肥胖、孕前糖尿病和县级农村地区均与婴儿巨大儿的发生几率增加显著相关。
