Boyer Theresa, Hsueh Christine, Sun Kevin, Adoma Kwapong Yaa, Jason Vaught Arthur, Echouffo Tcheugui Justin, Selvin Elizabeth, Ndumele Chiadi E, Hays Allison G, Michos Erin D, Coresh Josef, Minhas Anum S
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Division of Cardiology, Yale University School of Medicine, New Haven, Connecticut, USA.
JACC Asia. 2024 Sep 24;4(11):842-852. doi: 10.1016/j.jacasi.2024.07.010. eCollection 2024 Nov.
Asian individuals are among the highest immigrant group to the United States and at particularly high risk of gestational diabetes, which is associated with long-term maternal cardiovascular disease. Limited data are available on the association of prepregnancy cardiometabolic risk factors with gestational diabetes among Asian American subjects.
This study sought to determine the association of prepregnancy hypertension and body mass index (BMI) among Asian ancestry subgroups and by maternal nativity.
Using data from the National Vital Statistics System from 2016 to 2019, the prevalence of gestational diabetes, stratified according to prepregnancy hypertension and obesity, was examined according to maternal race. Predicted probability of gestational diabetes with continuous BMI was calculated across Asian ancestry subgroups and by maternal nativity.
Among 13.3 million pregnancies, gestational diabetes occurred in 6.5%. Asian subjects had the highest prevalence (12.3%). Among those with prepregnancy hypertension, Asian subjects had the highest prevalence (29.3%). Across the range of BMI (18-42 kg/m), Asian subjects had the highest predicted probability. There was substantial heterogeneity across Asian ancestry subgroups between the association of BMI with gestational diabetes, with highest probability among Japanese and Korean American subjects at BMI >23 kg/m. Predicted probability of gestational diabetes was higher for mothers born outside the United States among all Asian subgroups, except for Japanese American subjects.
Asian American individuals have the highest prevalence of gestational diabetes at any BMI and with hypertension. Substantial variation in risk is present across Asian subgroups. Findings suggest a need for more tailored screening and intervention for gestational diabetes among Asian American subjects, with a specific focus on risk for individuals born outside the United States.
亚洲人是移民到美国的人数最多的群体之一，患妊娠糖尿病的风险特别高，而妊娠糖尿病与长期的母亲心血管疾病有关。关于孕前心脏代谢危险因素与亚裔美国受试者妊娠糖尿病之间的关联，现有数据有限。
本研究旨在确定亚洲血统亚组以及按母亲出生地划分的孕前高血压与体重指数（BMI）之间的关联。
利用2016年至2019年国家生命统计系统的数据，根据孕前高血压和肥胖情况对妊娠糖尿病的患病率进行分层，并按母亲种族进行检查。计算了亚洲血统亚组以及按母亲出生地划分的连续BMI对应的妊娠糖尿病预测概率。
在1330万例妊娠中，6.5%发生了妊娠糖尿病。亚洲受试者的患病率最高（12.3%）。在孕前患有高血压的人群中，亚洲受试者的患病率最高（29.3%）。在整个BMI范围（18 - 42kg/m²）内，亚洲受试者的预测概率最高。BMI与妊娠糖尿病之间的关联在亚洲血统亚组之间存在很大异质性，在BMI>23kg/m²的日裔和韩裔美国受试者中概率最高。除日裔美国受试者外，所有亚洲亚组中在美国境外出生的母亲患妊娠糖尿病的预测概率更高。
在任何BMI水平以及患有高血压的情况下，亚裔美国人患妊娠糖尿病的患病率最高。亚洲亚组之间的风险存在很大差异。研究结果表明，需要针对亚裔美国受试者进行更有针对性的妊娠糖尿病筛查和干预，特别关注在美国境外出生的个体的风险。
