Mothers at increased risk for gestational diabetes in Massachusetts

Background: The proportion of mothers developing gestational diabetes among Massachusetts resident women increased by 19%, between 2001 and 2005. This proportion varies by maternal, infant, and pregnancy characteristics. For instance, young mothers giving birth to high-birthweight (HBW) infants (>9 lbs), and older mothers giving birth to low-birthweight (LBW) infants (<5.5 lbs) have higher proportions of gestational diabetes, than their same age peers giving birth to normal-birthweight (5.5-9 lbs) infants. We need to better understand the interaction of all these characteristics, including disparities with gestational diabetes among Massachusetts pregnant women. Study Question: Who are at an increased risk for gestational diabetes in Massachusetts?

Methods: Using all live births to 2004-2005 Massachusetts residents, we applied univariate analysis and logistic regression models to identify maternal (age, education, race/ethnicity, place-born, cesarean history), infant birthweight, and pregnancy characteristics (gestational age, parity, plurality) associated with increased risk for gestational diabetes. Adjusted odd ratios (OR) were used to identify vulnerable groups.

Results: In 2004-2005, 5,769 (3.8%) of Massachusetts pregnant women developed gestational diabetes. Groups of Massachusetts pregnant women with increased odds of gestational diabetes include those women >35 yrs (OR:4.25, 95%CI:3.82-4.74), Haitian (OR:1.78, 95%CI:1.07-2.08), delivering multiples (OR:1.42, 95%CI:1.26-1.59), HBW infants (>9lbs) (OR:1.43, 95%CI:1.31-1.57), with a prior cesarean (OR:1.35, 95%CI:1.25-1.45) among others, after controlling for all other variables.

Conclusions: Massachusetts women increase their risk for gestational diabetes with age, when carrying HBW fetus or multiple fetuses. Further work is needed to understand why Haitian mothers have an increased risk for gestational diabetes.