Abstract
Introduction Gestational diabetes mellitus (GDM) is diabetes that is newly developed by women during pregnancy. There is an existing gap in the literature in the United States on the relationship between race and GDM; the results of this study will seek to address this gap by examining pregnant women of color in comparison to their White, non-Hispanic (NH) counterparts. Given the potential health risks posed by GDM and the overall impact of the social determinants of health, it is essential to address racial disparities in GDM. Methods A retrospective cohort study was conducted using data representative of the United States, which was acquired from the National Vital Statistics System (NVSS) from the National Center for Health Statistics (NCHS). The racial groups investigated included NH White, NH Black, NH American Indian or Alaskan Native/Native Hawaiian or Other Pacific Islander (AIAN/NHOPI), NH Asian, NH Mixed, and Hispanic women, while the outcome of interest was diagnosis of GDM. Initially, the sample's baseline characteristics were evaluated, followed by a bivariate analysis to ascertain any association between the exposure and outcome, as well as to pinpoint potential confounders. Ultimately, we conducted a multivariable analysis to control for confounders. Results A total of 3,367,601 women were included in our study. Most women included were NH White women (50.5%), followed by Hispanic women (26.5%), NH Black women (13.5%), and NH Asian women (6.1%). The adjusted odds of GDM were more than twice as high in NH Asian women when compared with NH White women (adjusted odds ratio (aOR) 2.79; 95% confidence interval (CI) 2.75-2.83), and were also increased in the NH AIAN/NHOPI women (aOR 1.61; 95% CI 1.55-1.67), NH Mixed women (aOR 1.08; 95% CI 1.05-1.11), and Hispanic women (aOR 1.16; 95% CI 1.15-1.17), but decreased in NH Black women (aOR 0.76; 95% CI 0.75-0.77). Conclusion Overall, our study found that GDM is associated with the race/ethnicity of mothers. NH Asian and NH AIAN/NHOPI women had the highest rates of GDM when compared with their NH White counterparts. Future research should examine subgroups within larger race categories to better understand the nuances of their experiences and other GDM risk factors, such as the psychosocial experiences of racism and discrimination.