Stephanie H Read1,2, Laura C Rosella2,3,4, Howard Berger5, Denice S Feig2,6,7,8, Karen Fleming9, Joel G Ray2,6,7,10, Baiju R Shah2,6,7,11, Lorraine L Lipscombe12,13,14,15. 1. Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada. 2. ICES, Toronto, ON, Canada. 3. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 4. Public Health Ontario, Toronto, ON, Canada. 5. Division of Maternal-Fetal Medicine, St Michael's Hospital, Toronto, ON, Canada. 6. Department of Medicine, University of Toronto, Toronto, ON, Canada. 7. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. 8. Sinai Health System, Toronto, ON, Canada. 9. Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. 10. Department of Obstetrics and Gynaecology, St Michael's Hospital, Toronto, ON, Canada. 11. Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. 12. Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada. Lorraine.lipscombe@wchospital.ca. 13. ICES, Toronto, ON, Canada. Lorraine.lipscombe@wchospital.ca. 14. Department of Medicine, University of Toronto, Toronto, ON, Canada. Lorraine.lipscombe@wchospital.ca. 15. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. Lorraine.lipscombe@wchospital.ca.
Abstract
AIMS/HYPOTHESIS: The aim of this study was to examine how BMI influences the association between Asian ethnicity and risk of gestational diabetes (GDM). METHODS: This population-based cohort study included pregnant women without pre-existing diabetes mellitus in Ontario, Canada between 2012 and 2014. Women of Chinese and South Asian ethnicity were identified using a validated surname algorithm. GDM was ascertained using hospitalisation codes. The relationship between ethnicity and GDM was modelled using modified Poisson regression, adjusted for maternal age, pre-pregnancy BMI, parity, previous GDM, long-term residency status, income quintile and smoking status. An interaction term between ethnicity and pre-pregnancy BMI was tested. RESULTS: Of 231,618 pregnant women, 9289 (4.0%) were of South Asian ethnicity and 12,240 (5.3%) were of Chinese ethnicity. Relative to women from the general population, in whom prevalence of GDM was 4.3%, the adjusted RR of GDM was higher among those of South Asian ethnicity (1.81 [95% CI 1.64, 1.99]) and Chinese ethnicity (1.66 [95% CI 1.53, 1.80]). The association between GDM and Asian ethnicity remained significant across BMI categories but differed according to BMI. The prevalence of GDM exceeded 5% at an estimated BMI of 21.5 kg/m2 among South Asian women, 23.0 kg/m2 among Chinese women and 29.5 kg/m2 among the general population. CONCLUSIONS/ INTERPRETATION: The risk of GDM is significantly higher in South Asian and Chinese women, whose BMI is lower than that of women in the general population. Accordingly, targeted GDM prevention strategies may need to consider lower BMI cut-points for Asian populations.
AIMS/HYPOTHESIS: The aim of this study was to examine how BMI influences the association between Asian ethnicity and risk of gestational diabetes (GDM). METHODS: This population-based cohort study included pregnant women without pre-existing diabetes mellitus in Ontario, Canada between 2012 and 2014. Women of Chinese and South Asian ethnicity were identified using a validated surname algorithm. GDM was ascertained using hospitalisation codes. The relationship between ethnicity and GDM was modelled using modified Poisson regression, adjusted for maternal age, pre-pregnancy BMI, parity, previous GDM, long-term residency status, income quintile and smoking status. An interaction term between ethnicity and pre-pregnancy BMI was tested. RESULTS: Of 231,618 pregnant women, 9289 (4.0%) were of South Asian ethnicity and 12,240 (5.3%) were of Chinese ethnicity. Relative to women from the general population, in whom prevalence of GDM was 4.3%, the adjusted RR of GDM was higher among those of South Asian ethnicity (1.81 [95% CI 1.64, 1.99]) and Chinese ethnicity (1.66 [95% CI 1.53, 1.80]). The association between GDM and Asian ethnicity remained significant across BMI categories but differed according to BMI. The prevalence of GDM exceeded 5% at an estimated BMI of 21.5 kg/m2 among South Asian women, 23.0 kg/m2 among Chinese women and 29.5 kg/m2 among the general population. CONCLUSIONS/ INTERPRETATION: The risk of GDM is significantly higher in South Asian and Chinese women, whose BMI is lower than that of women in the general population. Accordingly, targeted GDM prevention strategies may need to consider lower BMI cut-points for Asian populations.
Authors: Iris Shai; Rui Jiang; Joann E Manson; Meir J Stampfer; Walter C Willett; Graham A Colditz; Frank B Hu Journal: Diabetes Care Date: 2006-07 Impact factor: 19.112
Authors: Monique M Hedderson; Michelle A Williams; Victoria L Holt; Noel S Weiss; Assiamira Ferrara Journal: Am J Obstet Gynecol Date: 2008-02-20 Impact factor: 8.661
Authors: Susan Y Chu; William M Callaghan; Shin Y Kim; Christopher H Schmid; Joseph Lau; Lucinda J England; Patricia M Dietz Journal: Diabetes Care Date: 2007-04-06 Impact factor: 19.112