Racial/ethnic disparities in gestational diabetes mellitus in Oregon

Introduction: Gestational diabetes mellitus (GDM) affects approximately 3-8% of all pregnant women; prevalence is highest among women from racial/ethnic minorities. The purpose of this project was to determine risk factors for GDM among Oregon women. Factors such as pre-pregnancy body mass index, race/ethnicity, and maternal age were assessed. Method: Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) surveyed, from their birth certificates, a stratified random sample of postpartum women who delivered in Oregon in 2001 (n=1783; unweighted response rate 72.1%; weighted response rate 78.1%). Hispanic, non-Hispanic black, non-Hispanic American Indian and non-Hispanic Asian/Pacific Islander women were oversampled. GDM was ascertained from birth certificates. We used logistic regression to assess risk factors for GDM using STATA 9.0 to account for weighted data. Oregon PRAMS 2001 data was not collected under CDC protocol. Results: A pre-pregnancy body mass index >25 (overweight or obese), increased a women's risk for GDM (OR 2.64, 95% confidence interval (95% CI) = 1.10-6.36). Asian/Pacific Islander women had the greatest incidence of GDM (7.0%) followed by Hispanic women (4.2%) and non-Hispanic American Indians (4.0%). Maternal age >25 also increases the risk for GDM (OR 1.10, CI = 1.03-1.18). Conclusion: A disproportionate number of non-Hispanic Asian/Pacific Islander and Hispanic women have pregnancies complicated by GDM. Public Health Implications: Health care practitioners need to be vigilant to the prevention and educational needs of gestational diabetic women during and after pregnancy. Public health programs need to encourage early detection and aggressive treatment of GDM, especially among high risk women.