Interaction of body weight and ethnicity on risk of gestational diabetes mellitus

Abstract

The James Bay Cree of Canada have one of the highest recorded rates of gestational diabetes mellitus (GDM) among aboriginal people worldwide; the reasons for this elevated risk remain to be documented. Our objective was to compare predictors and risk of GDM between the James Bay Cree and non-Native Canadians. Risk for GDM was compared between Cree and non-Native women by 1) adjusting statistically for differences in age, parity, pregravid weight, and smoking status (n = 402 Cree, 7718 non-Natives), and 2) matching Cree women with non-Native women for age and pregravid weight (n = 394 Cree, 788 non-Natives). Dietary and physical activity information was available for a subset of Cree women (n = 152). Age and pregravid weight were independent predictors of GDM in both Cree and non-Native women. After these predictors were controlled for, normal-weight (</=77 kg) Cree women were not at increased risk of GDM (OR: 1.42; 95% CI: 0.67, 2.71) but overweight Cree women had a higher risk than did overweight non-Native women (OR: 2.25; 95% CI: 1.32, 3.80). Overweight Cree women are at increased risk of GDM. Given the high prevalence of pregravid overweight among the Cree, the burden of GDM is higher than among non-Native Canadians.