Chern Ingrid, Choi So Yung, Ahn Hyeong Jun, Mau Marjorie, Yamasato Kelly
Department of Obstetrics, Gynecology, and Women's Health, University of Hawai'i at Mānoa John A Burns School of Medicine, 1319 Punahou Street Suite 824, Honolulu, HI, 96826, USA.
Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Matern Child Health J. 2025 Sep 1. doi: 10.1007/s10995-025-04151-1.
To assess racial/ethnic differences in gestational diabetes mellitus (GDM) prevalence in Hawai'i.
This retrospective cross-sectional study included hospital deliveries at Kapi'olani Medical Center for Women and Children (Honolulu, Hawai'i) from 2009 to 2019. For birthing people with multiple deliveries during the study interval, only the last delivery was included. Birthing people with pregestational diabetes, delivery < 29 weeks, and multifetal gestations were excluded. GDM was identified through ICD-9 and -1 0 codes. Race and ethnicity were self-reported. Maternal body mass index (BMI) was recorded at delivery admission. GDM prevalence was determined for each race and the odds examined using logistic regression, also adjusting for maternal age and BMI. For analysis, three racial groups were sub-grouped into six ethnic categories as described: the three major racial groups were: (i) Asian, (ii) Native Hawaiian/Pacific Islander, and (iii) White. Six major ethnic sub-categories in the Asian racial group included: East Asians-identified as (1) Chinese/Taiwanese, (2) Japanese/Okinawan, (3) South East Asians identified as Filipino, (4) Native Hawaiian and (5) Pacific Islander identified as Micronesian/Samoan, and (6) White.
Of 57,031 deliveries, 31,663 were included in this study. Overall crude prevalence of GDM was estimated at 11.7%. The three Asian ethnic sub-categories had approximately twice the risk of GDM when compared to Whites (Filipina: OR 2.59, 95% CI = [2.27-2.96], Chinese/Taiwanese: OR = 2.38, 95% CI = [2.01-2.82], and Japanese/Okinawan: OR = 1.71, 95% CI = [1.47-1.99]). Native Hawaiians also had higher GDM prevalence estimates compared to Whites (OR = 1.50, 95% CI = [1.31-1.71]), though there was no significant difference for Pacific Islanders (OR = 1.14, 95% CI = [0.97-1.33]).
Prevalence of GDM in hospitalized deliveries in Hawai'i's multi-ethnic population of women has increased nearly 2-fold in the last two decades. All Asian Americans remain at highest risk despite lower maternal BMI at delivery. NH women are younger yet have similar frequency of co-morbidities and comprise the largest proportion of GDM cases overall.
评估夏威夷妊娠期糖尿病（GDM）患病率的种族/民族差异。
这项回顾性横断面研究纳入了2009年至2019年在卡皮奥拉尼妇女儿童医院（夏威夷檀香山）的医院分娩病例。对于在研究期间多次分娩的产妇，仅纳入最后一次分娩。排除孕前糖尿病、孕周小于29周以及多胎妊娠的产妇。通过ICD - 9和ICD - 10编码确定GDM。种族和民族由产妇自我报告。在分娩入院时记录产妇的体重指数（BMI）。确定每个种族的GDM患病率，并使用逻辑回归分析比值比，同时对产妇年龄和BMI进行调整。为了进行分析，如前所述，将三个种族组细分为六个民族类别：三个主要种族组为：（i）亚洲人，（ii）夏威夷原住民/太平洋岛民，（iii）白人。亚洲种族组中的六个主要民族子类别包括：东亚人，被确定为（1）中国人/台湾人，（2）日本人/冲绳人，（3）被确定为菲律宾人的东南亚人，（4）夏威夷原住民，以及（5）被确定为密克罗尼西亚人/萨摩亚人的太平洋岛民，（6）白人。
在57,031例分娩中，本研究纳入了31,663例。GDM的总体粗患病率估计为11.7%。与白人相比，三个亚洲民族子类别患GDM的风险大约是其两倍（菲律宾人：比值比2.59，95%置信区间 = [2.27 - 2.96]，中国人/台湾人：比值比 = 2.38，95%置信区间 = [2.01 - 2.82]，日本人/冲绳人：比值比 = 1.71，95%置信区间 = [1.47 - 1.99]）。与白人相比，夏威夷原住民的GDM患病率估计也更高（比值比 = 1.50，95%置信区间 = [1.31 - 1.71]），不过太平洋岛民与白人之间没有显著差异（比值比 = 1.14，95%置信区间 = [0.97 - 1.33]）。
在过去二十年中，夏威夷多民族女性住院分娩中GDM的患病率几乎增加了两倍。尽管分娩时产妇BMI较低，但所有亚裔美国人仍然风险最高。夏威夷原住民女性更年轻，但合并症发生率相似，且在总体GDM病例中占比最大。
