201596 Ethnic differences in adverse birth events among women with gestational diabetes mellitus

Sunday, November 8, 2009

Michelle Dembiski, MPH Candidate , Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY
David Savitz, PhD , Department of Community and Preventive Medicine, Mt. Sinai School of Medicine, New York, NY
Regina Zimmerman, PhD, MPH , Office of Vital Statistics, New York City Department of Health and Mental Hygiene, New York, NY
There is limited and inconsistent evidence regarding ethnic variation in the impact of GDM on birth outcome. To investigate this topic further, the authors examined the impact of GDM on pregnancy-induced hypertension, macrosomia, primary Cesarean delivery, and preterm birth, using New York City Birth Certificate data from 2001-- 2006. GDM was associated with increased risk of adverse perinatal events among all groups, with modest variation by ethnicity. Across ethnic groups, adjusted odds ratios comparing women with and without GDM ranged from 1.1 to 2.9 for pregnancy-induced hypertensive disorder, 0.9 to 1.9 for macrosomia, 1.1 to 1.8 for primary Cesarean delivery, and 0.9 to 2.0 for preterm birth. Overall, Caribbean, Sub-Saharan African, and African American women tended to show larger impact of GDM, while North African, South Central Asian, and Chinese women showed a comparatively smaller impact of GDM. Although some ethnic variation was seen, differences in effect size were not large enough to support ethnic specific thresholds for GDM diagnosis and treatment.

Learning Objectives:
1. Evaluate ethnic differences in adverse birth events, specifically pregnancy-induced hypertensive disorders, unplanned Cesarean section, preterm birth, and macrosomia, among women with gestational diabetes mellitus. 2. Identify ethnic groups with the greatest risk for pregnancy-induced hypertensive disorders, unplanned Cesarean section, preterm birth, and macrosomia in the presence of gestational diabetes mellitus. 3. Determine to what degree minority women with gestational diabetes mellitus are at higher risk for measured adverse birth events than non-Hispanic white women without gestational diabetes mellitus.

Keywords: Diabetes, Minority Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved in conducting research for over 9 years and will receive my MPH in epidemiology from Columbia University in May 2009. I have been involved with nearly every aspect of research from designing studies through data analysis and presentation of results. I have previously presented two posters at major conferences and have co-authored an article in the Journal of Anxiety Disorders. This past summer I worked at the Office of Vital Statistics at the New York City of Department of Health and Mental Hygiene (DOHMH) which is where I began to work with the Birth Certificate data used in this study. Since completing my internship, I have continued to work with individuals at the DOHMH to conduct this research as well as with Dr. David Savitz from Mt. Sinai.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.