Abstract 12401: Cardiovascular Risk Profile and Gestational Diabetes Mellitus by Maternal Nativity and Length of US Residence in Racially Diverse, Urban, Low Income Population in the United States

Abstract

Introduction: Gestational diabetes mellitus (GDM) is independently associated with increased cardiovascular disease (CVD) risk. GDM disproportionately affects non-Hispanic Black (NHB) women in the United States (US). The prevalence of GDM by nativity (US born versus foreign born) and duration of US residence is not well known in other race/ethnicities. Methods: We analyzed 6088 women with data on GDM from the Boston Birth Cohort. We performed multivariable logistic regression to investigate the association of nativity and duration of US residence (<10 versus ≥10 years residence) with GDM by race (NHB, Hispanic, and White). Covariates included sociodemographic characteristics and CVD risk factors. Results: In our sample, 44.3% were NHB, 39.3% Hispanic, and 16.4% White. Foreign born NHB and Hispanic women with duration of US residence <10 years had lower prevalence of CVD risk factors (multiparity, severe stress, chronic hypertension, smoking in pregnancy, obesity BMI ≥ 30 kg/m2) than those with ≥10 years US residence and US born women. Foreign born NHB with duration of US residence <10 years had higher odds of GDM (adjusted OR, aOR: 1.6, 95%CI 0.99-2.6, p=0.05) compared to US born NHB women, while in contrast foreign born Hispanic women with duration of US residence <10 years had lower odds for GDM (aOR 0.54, 95%CI 0.32-0.91, p=0.021). The odds of GDM in Hispanic and NHB women with US residence ≥ 10 years was not significantly different from their US born counterparts. Conclusions: GDM prevalence is higher in foreign-born NHB women with shorter duration of US residence, despite better risk factor profiles. GDM is lower in foreign-born Hispanic women with shorter duration of US residence, mirroring their better risk factor profile. Thus, the “healthy immigrant effect” (health advantages for foreign-born women), appears to not apply to GDM in NHB. Further research is needed to examine why GDM burden in NHB women is not well explained by risk factor burden or environmental stress.