Gestational diabetes risk in a multi-ethnic population

Anat Jaffe,Arnona Ziv,Ofra Kalter-Leibovici,Shmuel Giveon,Carmit Rubin,Ilya Novikov

doi:10.1007/s00592-019-01404-8

Abstract

AimsTo compare gestational diabetes mellitus (GDM) risk among two ethnic minority groups, with high type-2 diabetes (T2DM) prevalence, as compared to the Jewish population majority group.MethodsA historical cohort study was conducted using clinical data collected between January 1, 2007, and December 31, 2011. The study sample included 20–45-year-old women; 2938 Ethiopian, 5849 Arab and 5156 non-Ethiopian Jewish women. GDM was defined according to the two-step strategy: step 1: glucose ≥ 140 mg/dl and step 2: using Coustan and Carpenter’s diagnostic criteria. GDM risk was tested in a multivariable model, adjusted for age, parity and pre-gestational values of the metabolic syndrome components.ResultsMean body mass index (BMI) values and morbid obesity rates were lowest among Ethiopian women and highest among Arab women. The prevalence of pre-gestational diabetes was significantly higher among Ethiopian (2.7%) and Arab (4.1%) women than among non-Ethiopian Jewish women (1.6%), and GDM screening rates were relatively high (85.5%, 87.2% and 83%, respectively). The proportion of pregnancies complicated with GDM was higher among Ethiopian women (4.3%) but not significantly different between Arab (2.9%) and non-Ethiopian Jewish (2.2%) women. In multivariable analysis, GDM was associated with Ethiopian ancestry (OR, 2.55; 95% CI, 1.60–4.08), adjusted for age, BMI, plasma triglyceride level and parity. Arab ethnicity was not significantly associated with GDM risk in multivariable analysis.ConclusionsBoth Ethiopian and Arab minority ethnicities have a higher risk of T2DM in comparison with other Israeli women, but only Ethiopian origin is an independent risk factor for GDM while Arab ethnicity is not.

Highlights

Gestational diabetes mellitus (GDM) defined as glucose intolerance first diagnosed during pregnancy is associated with a higher risk of adverse obstetric and perinatal outcomes [1, 2]
BMI body mass index, HDL-C high-density lipoprotein cholesterol, SBP systolic blood pressure, GDM gestational diabetes mellitus a Among women who delivered during the study period b Including one-step and two-step screening
Arab ethnicity was not found to be significantly associated with a greater risk of GDM, Arab women had higher prevalence of pre-gestational diabetes compared to non-Ethiopian Jewish women

Summary

Introduction

Gestational diabetes mellitus (GDM) defined as glucose intolerance first diagnosed during pregnancy is associated with a higher risk of adverse obstetric and perinatal outcomes [1, 2]. Women with GDM have sevenfold greater risk of developing type-2 diabetes (T2DM) 5–10 years after delivery [3], and offspring of mothers with GDM have higher obesity and diabetes mellitus (DM) rates later in life [4, 5]. The prevalence of GDM and T2DM differs among ethnic minority groups [6, 7]. Arabs are the largest ethnic minority group in Israel, accounting for 21% of the population [10]. Arab women have high prevalence of obesity and central obesity [11] and higher risk of T2DM compared to the Jewish female majority population [12]

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Results

Discussion

Conclusion