TY - JOUR
T1 - Trends in Gestational Diabetes at First Live Birth by Race and Ethnicity in the US, 2011-2019
AU - Shah, Nilay S.
AU - Wang, Michael C.
AU - Freaney, Priya M.
AU - Perak, Amanda M.
AU - Carnethon, Mercedes R.
AU - Kandula, Namratha R.
AU - Gunderson, Erica P.
AU - Bullard, Kai Mc Keever
AU - Grobman, William A.
AU - O'Brien, Matthew J.
AU - Khan, Sadiya S.
N1 - Funding Information:
receiving grants from the National Institutes of
Funding Information:
publication was supported, in part, by the National Heart, Lung, and Blood Institute grant F32HL149187 (Dr Shah) and the National Institutes of Health grants KL2TR001424, P30AG059988, and P30DK092939 (Dr Khan). Research reported in this publication was also supported, in part, by the American Heart Association (#19TPA34890060; Dr Khan).
Funding Information:
Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI) during the conduct of the study. Mr Wang reported receiving grants from the American Heart Association (#19TPA34890060; primary investigator: Sadiya S. Khan, MD, MSc) during the conduct of the study. Dr Perak reported receiving grants from the NHLBI (K23HL145101) during the conduct of the study. Dr Gunderson reported receiving grants from National Institute of Diabetes and Digestive and Kidney Diseases as the primary investigator of several research projects funded to evaluate gestational diabetes and cardiometabolic risk in women and youth, the NHLBI as the primary investigator of research on pregnancy blood pressure patterns, the American Heart Association as a co–primary investigator in a study of epigenetic markers of gestational diabetes, and the NHLBI for research funding as the CARDIA study co-chair of the CARDIA Pregnancy-Related Exposure Working Group outside the submitted work and having a patent for Metabolite signature to predict progression to type 2 diabetes after gestational diabetes pending, for which Kaiser Foundation Research Institute has rights to the patent and she is a co-inventor. Dr O'Brien reported receiving grants from the UnitedHealth Group outside the submitted work. Dr Khan reported receiving grants from the American Heart Association (#19TPA34890060) and the NIH (P30DK092939 and P30AG059988) during the conduct of the study. No other disclosures were reported.
Publisher Copyright:
© 2021 American Medical Association. All rights reserved.
PY - 2021/8/17
Y1 - 2021/8/17
N2 - Importance: Gestational diabetes is associated with adverse maternal and offspring outcomes. Objective: To determine whether rates of gestational diabetes among individuals at first live birth changed from 2011 to 2019 and how these rates differ by race and ethnicity in the US. Design, Setting, and Participants: Serial cross-sectional analysis using National Center for Health Statistics data for 12610235 individuals aged 15 to 44 years with singleton first live births from 2011 to 2019 in the US. Exposures: Gestational diabetes data stratified by the following race and ethnicity groups: Hispanic/Latina (including Central and South American, Cuban, Mexican, and Puerto Rican); non-Hispanic Asian/Pacific Islander (including Asian Indian, Chinese, Filipina, Japanese, Korean, and Vietnamese); non-Hispanic Black; and non-Hispanic White. Main Outcomes and Measures: The primary outcomes were age-standardized rates of gestational diabetes (per 1000 live births) and respective mean annual percent change and rate ratios (RRs) of gestational diabetes in non-Hispanic Asian/Pacific Islander (overall and in subgroups), non-Hispanic Black, and Hispanic/Latina (overall and in subgroups) individuals relative to non-Hispanic White individuals (referent group). Results: Among the 12610235 included individuals (mean [SD] age, 26.3 [5.8] years), the overall age-standardized gestational diabetes rate significantly increased from 47.6 (95% CI, 47.1-48.0) to 63.5 (95% CI, 63.1-64.0) per 1000 live births from 2011 to 2019, a mean annual percent change of 3.7% (95% CI, 2.8%-4.6%) per year. Of the 12610235 participants, 21% were Hispanic/Latina (2019 gestational diabetes rate, 66.6 [95% CI, 65.6-67.7]; RR, 1.15 [95% CI, 1.13-1.18]), 8% were non-Hispanic Asian/Pacific Islander (2019 gestational diabetes rate, 102.7 [95% CI, 100.7-104.7]; RR, 1.78 [95% CI, 1.74-1.82]), 14% were non-Hispanic Black (2019 gestational diabetes rate, 55.7 [95% CI, 54.5-57.0]; RR, 0.97 [95% CI, 0.94-0.99]), and 56% were non-Hispanic White (2019 gestational diabetes rate, 57.7 [95% CI, 57.2-58.3]; referent group). Gestational diabetes rates were highest in Asian Indian participants (2019 gestational diabetes rate, 129.1 [95% CI, 100.7-104.7]; RR, 2.24 [95% CI, 2.15-2.33]). Among Hispanic/Latina participants, gestational diabetes rates were highest among Puerto Rican individuals (2019 gestational diabetes rate, 75.8 [95% CI, 71.8-79.9]; RR, 1.31 [95% CI, 1.24-1.39]). Gestational diabetes rates increased among all race and ethnicity subgroups and across all age groups. Conclusions and Relevance: Among individuals with a singleton first live birth in the US from 2011 to 2019, rates of gestational diabetes increased across all racial and ethnic subgroups. Differences in absolute gestational diabetes rates were observed across race and ethnicity subgroups..
AB - Importance: Gestational diabetes is associated with adverse maternal and offspring outcomes. Objective: To determine whether rates of gestational diabetes among individuals at first live birth changed from 2011 to 2019 and how these rates differ by race and ethnicity in the US. Design, Setting, and Participants: Serial cross-sectional analysis using National Center for Health Statistics data for 12610235 individuals aged 15 to 44 years with singleton first live births from 2011 to 2019 in the US. Exposures: Gestational diabetes data stratified by the following race and ethnicity groups: Hispanic/Latina (including Central and South American, Cuban, Mexican, and Puerto Rican); non-Hispanic Asian/Pacific Islander (including Asian Indian, Chinese, Filipina, Japanese, Korean, and Vietnamese); non-Hispanic Black; and non-Hispanic White. Main Outcomes and Measures: The primary outcomes were age-standardized rates of gestational diabetes (per 1000 live births) and respective mean annual percent change and rate ratios (RRs) of gestational diabetes in non-Hispanic Asian/Pacific Islander (overall and in subgroups), non-Hispanic Black, and Hispanic/Latina (overall and in subgroups) individuals relative to non-Hispanic White individuals (referent group). Results: Among the 12610235 included individuals (mean [SD] age, 26.3 [5.8] years), the overall age-standardized gestational diabetes rate significantly increased from 47.6 (95% CI, 47.1-48.0) to 63.5 (95% CI, 63.1-64.0) per 1000 live births from 2011 to 2019, a mean annual percent change of 3.7% (95% CI, 2.8%-4.6%) per year. Of the 12610235 participants, 21% were Hispanic/Latina (2019 gestational diabetes rate, 66.6 [95% CI, 65.6-67.7]; RR, 1.15 [95% CI, 1.13-1.18]), 8% were non-Hispanic Asian/Pacific Islander (2019 gestational diabetes rate, 102.7 [95% CI, 100.7-104.7]; RR, 1.78 [95% CI, 1.74-1.82]), 14% were non-Hispanic Black (2019 gestational diabetes rate, 55.7 [95% CI, 54.5-57.0]; RR, 0.97 [95% CI, 0.94-0.99]), and 56% were non-Hispanic White (2019 gestational diabetes rate, 57.7 [95% CI, 57.2-58.3]; referent group). Gestational diabetes rates were highest in Asian Indian participants (2019 gestational diabetes rate, 129.1 [95% CI, 100.7-104.7]; RR, 2.24 [95% CI, 2.15-2.33]). Among Hispanic/Latina participants, gestational diabetes rates were highest among Puerto Rican individuals (2019 gestational diabetes rate, 75.8 [95% CI, 71.8-79.9]; RR, 1.31 [95% CI, 1.24-1.39]). Gestational diabetes rates increased among all race and ethnicity subgroups and across all age groups. Conclusions and Relevance: Among individuals with a singleton first live birth in the US from 2011 to 2019, rates of gestational diabetes increased across all racial and ethnic subgroups. Differences in absolute gestational diabetes rates were observed across race and ethnicity subgroups..
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U2 - 10.1001/jama.2021.7217
DO - 10.1001/jama.2021.7217
M3 - Article
C2 - 34402831
AN - SCOPUS:85113136446
SN - 0098-7484
VL - 326
SP - 660
EP - 669
JO - JAMA - Journal of the American Medical Association
JF - JAMA - Journal of the American Medical Association
IS - 7
ER -
