Gestational diabetes mellitus among Sub-Saharan African and Surinamese women in the Netherlands

Abstract

AimWe assessed the association between ethnicity and the risk of gestational diabetes mellitus (GDM) in the Netherlands. MethodsA cohort of 7815 women with known GDM status and ethnicity, including women of Sub-Saharan African ethnicity who are currently not identified as high-risk in guidelines. We compared GDM rates among participants of ethnicity to those of ethnic Dutch participants. We employed multivariable regression to correct for possible confounders, including maternal age, pre-pregnancy body mass index (BMI), and education. GDM prevalence and odds ratios based on ethnicity were the main outcome measures. ResultsThe prevalence rates of GDM according to ethnicity were: Dutch 0.6%, South-Asian Surinamese 6.9%, African-Surinamese 3.5%, Antillean 1.0%, Turkish 1.0%, Moroccan 1.4%, Ghanaian 6.8%, Sub-Saharan African 3.5%, other Western 0.5% and other non-Western 2.8%. After adjustment for age, pre-pregnancy BMI, and education duration, compared with the reference Dutch-ethnicity population, adjusted odds ratios (aOR) for GDM were statistically significantly higher in South-Asian Surinamese (aOR 10.9; 95% Confidence Interval (CI), 4.7–25.0), African-Surinamese (4.3; 2.0–9.2), Ghanaian (6.5; 3.0–14.5), Sub-Saharan African (5.7; 2.0–16.0), and other non-Western women (4.5; 2.2–9.0). GDM was not significantly increased among Antillean (1.4; 0.2–10.3), Turkish (1.4; 0.4–4.2), Moroccan (1.8; 0.8–4.0), and other Western women (0.8; 0.3–2.2). ConclusionsThis study shows for the first time in the Netherlands that women of Ghanaian or other Sub-Saharan African ethnicity have an increased risk of developing GDM than the Dutch. This calls for adaptation of the Dutch guidelines of screening high-risk groups for GDM and more awareness amongst obstetric caregivers.