Ethnic Differences in Perinatal Outcome of Gestational Diabetes Mellitus
- Jana Kaida Silva, MD, FACOG1,
- Joseph Keawe‘aimoku Kaholokula, PHD1,
- Robert Ratner, MD2 and
- Marjorie Mau, MD1
- 1Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, Hawai‘i;
- 2MedStar Research Institute, Hyattsville, Maryland
- Address correspondence and reprint requests to Jana Kaida Silva, MD, FACOG, Native Hawaiian Health, JABSOM, 677 Ala Moana Blvd., Suite 1016B, Honolulu, HI 96813. E-mail: jksilva{at}hawaii.edu
Abstract
OBJECTIVE— Despite the high rates of gestational diabetes mellitus (GDM) among certain Pacific Islander and Asian ethnic groups in the U.S., little is known about the risk for adverse perinatal outcomes in these populations. We sought to examine ethnic differences in perinatal outcome among Asian and Pacific-Islander women with GDM.
RESEARCH DESIGN AND METHODS— A retrospective review of all women referred to the largest outpatient GDM program in the state of Hawai‘i from 1995 to 2005 was conducted. Patients of Native-Hawaiian/Pacific-Islander, Japanese, Chinese, Filipino, and Caucasian ethnicity were included (n = 2,155). Treatment of all patients consisted of an outpatient education class, dietary management, self-monitoring of blood glucose, and insulin instruction (if indicated). Demographics, maternal and neonatal characteristics, and delivery information were evaluated.
RESULTS— Neonates born to Native-Hawaiian/Pacific-Islander mothers and Filipino mothers had 4 and 2 times the prevalence of macrosomia, respectively, compared with neonates born to Japanese, Chinese, and Caucasian mothers. These differences persisted after adjustment for other statistically significant maternal and fetal characteristics. Ethnic differences were not observed for other neonatal or maternal complications associated with GDM, with the exception of neonatal hypoglycemia and hyperbilirubinemia.
CONCLUSIONS— Significant ethnic differences in perinatal outcomes exist across Asian and Pacific-Islander women with GDM. This finding emphasizes the need to better understand ethnic-specific factors in GDM management and the importance of developing ethnic-tailored GDM interventions to address these disparities.
Footnotes
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The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Kapi‘olani Medical Center for Women and Children.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Accepted May 23, 2006.
- Received February 27, 2006.
- DIABETES CARE
