Diabetes in Pregnant Hispanic Women
| Funding Source | OVPR, URC, Blue Cross Blue Shield of Michigan Foundation |
| Goals & Objectives: | There were two studies conducted in association with this project. One study examined the prevalence and risk factors for gestational diabetes (GDM) and one study examined the impact of maternal glucose tolerance on birth weight. |
| Communities Involved: |
2 cohorts (n=653 and n=372) of Hispanic mothers who received prenatal care at CHASS in southwest Detroit, and their infants who were born at Henry Ford Hospital. The GDM analysis was also conducted with a cohort of 552 African American women who received prenatal care and gave birth at Henry Ford. |
| Partners: | CHASS, UM Schools of Public Health and Medicine, Henry Ford System. |
| Intervention: | Not applicable. |
| Outcome Indicators: |
Gestational diabetes. Maternal weight, glucose tolerance and infant birth weight. |
| Methods & Analyses: | The data sources were a combination on prospective (Latinas) and retrospective medical record reviews from CHASS and Henry Ford Health System. Descriptive statistics, analyses of variance,and multiple linear and logistic analyses were conducted. |
| Results: |
Gestational Diabetes in Latino and African American women: Almost 47% of African Americans and 37% of Latinas were overweight or obese; 53% of African Americans and 38% or Latinas had excessive pregnancy weight gain. The prevalence of GDM was 3.9% among African Americans and 5.4% among Latinas. After adjusting for other risk factors, Latinas were 2.5 times more likely to develop GDM than African American women. Independent risk factors were family history of diabetes, age, body mass index and gestational weight gain prior to 28 weeks. [Kieffer E, Carman W, Gillespie B, Nolan G, Worley S, Guzman R. Obesity and Gestational Diabetes among African-American and Latino Women: Implications for Disparities in Women’s Health. Journal of the American Medical Women’s Association; 56: 181-187; 2001. Birth Weight among Latino infants: Abnormal glucose screens were evident in 27% of women; GDM prevalence was 5.1%. There was a significant relationship between increasing screening glucose value and adjusted birthweight (p<0.005). As glucose value increased, there was a significant trend toward increasing large-for-gestational age (LGA) (macrosomic) infants. In multivariate analyses, among women without diabetes, there was a 30.5 gram increase in birthweight;; a 17% increased risk of LGA and a 31% decreased risk of SGA. [Kieffer E, Nolan G, Carman W, Sanborn C, Guzman R, Ventura A. Glucose Tolerance During Pregnancy and Birth Weight in a Hispanic Population. Obstetrics and Gynecology. 94(5): 741-746; 1999]. Additional studies are possible using the large data set from these studies and combined with data from studies subsequently conducted. |