Abstract
Background: Ethnic minorities in Europe have high susceptibility to type 2 diabetes (T2DM) and, in some groups, also cardiovascular disease (CVD). Pregnancy can be considered a stress test that predicts future morbidity patterns in women and that affects future health of the child.Objective: To review ethnic differences in: 1) adiposity, hyperglycaemia, and pre-eclampsia during pregnancy; 2) future risk in the mother of obesity, T2DM and CVD; and 3) prenatal development and possible influences of maternal obesity, hyperglycaemia, and pre-eclampsia on offspring's future disease risk, as relevant for ethnic minorities in Europe of Asian and African origin.Design: Literature review.Results: Maternal health among ethnic minorities is still sparsely documented. Higher pre-pregnant body mass index (BMI) is found in women of African and Middle Eastern descent, and lower BMI in women from East and South Asia compared with women from the majority population. Within study populations, risk of gestational diabetes mellitus (GDM) is considerably higher in many minority groups, particularly South Asians, than in the majority population. This increased risk is apparent at lower BMI and younger ages. Women of African origin have higher risk of pre-eclampsia. A GDM pregnancy implies approximately seven-fold higher risk of T2DM than normal pregnancies, and both GDM and pre-eclampsia increase later risk of CVD. Asian neonates have lower birth weights, and mostly also African neonates. This may translate into increased risks of later obesity, T2DM, and CVD. Foetal overgrowth can promote the same conditions. Breastfeeding represents a possible strategy to reduce risk of T2DM in both the mother and the child.Conclusions: Ethnic minority women in Europe with Asian and African origin and their offspring seem to be at increased risk of T2DM and CVD, both currently and in the future. Pregnancy is an important window of opportunity for short and long-term disease prevention.
Highlights
Ethnic minorities in Europe have high susceptibility to type 2 diabetes (T2DM) and, in some groups, cardiovascular disease (CVD)
The aim of this article is to review the literature about differences between ethnic groups of Asian and African origin and the majority population in European countries, respectively, regarding the following topics: 1) adiposity, hyperglycaemia, and pre-eclampsia in pregnancy; 2) future risk for the mothers of obesity, type 2 diabetes mellitus (T2DM), and cardiovascular diseases (CVD); and 3) prenatal development and possible influences of maternal obesity, hyperglycaemia, and pre-eclampsia on the child’s future risk of obesity, T2DM, and CVD
Pre-pregnant body mass index (BMI) appears to be heterogeneous between groups, but the studies point to higher levels of obesity in women of African, possibly Middle Eastern descent, while women from South and East Asia tend to have lower BMI than the majority populations
Summary
Ethnic minorities in Europe have high susceptibility to type 2 diabetes (T2DM) and, in some groups, cardiovascular disease (CVD). Objective: To review ethnic differences in: 1) adiposity, hyperglycaemia, and pre-eclampsia during pregnancy; 2) future risk in the mother of obesity, T2DM and CVD; and 3) prenatal development and possible influences of maternal obesity, hyperglycaemia, and pre-eclampsia on offspring’s future disease risk, as relevant for ethnic minorities in Europe of Asian and African origin. Risk of gestational diabetes mellitus (GDM) is considerably higher in many minority groups, South Asians, than in the majority population. This increased risk is apparent at lower BMI and younger ages. Conclusions: Ethnic minority women in Europe with Asian and African origin and their offspring seem to be at increased risk of T2DM and CVD, both currently and in the future. Pregnancy is an important window of opportunity for short and long-term disease prevention
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