Impact of maternal diabetes on birthweight is greater in non-Hispanic blacks than in non-Hispanic whites

Abstract

Aims/hypothesis To determine the impact of maternal diabetes during pregnancy on racial disparities in fetal growth. Methods Using linked birth certificate, inpatient hospital and prenatal claims data we examined live singleton births of mothers resident in South Carolina who self-reported their race as non-Hispanic white (NHW; n=140,128) or non-Hispanic black (NHB; n=82,492) and delivered at 28-42 weeks' gestation between 2004 and 2008. Results Prepregnancy diabetes prevalence was higher in NHB (3.0%) than in NHW (1.7%), while the prevalence of gestational diabetes mellitus (GDM) was similar in NHB (6.1%) and NHW (6.3%). At a delivery BMI of 35 kg/m2, GDM exposure was associated with an average birthweight only 17 g (95% CI 4, 30) higher in NHW, but 78 g (95%CI 61, 95) higher in NHB (controlling for gestational age, maternal age, infant sex and availability of information on prenatal care). Figures for prepregnancy diabetes were 58 g (95% CI 34, 81) in NHWand 60 g (95% CI 37, 84) in NHB. GDM had a greater impact on birthweight in NHB than in NHW (60 g racial difference [95% CI 39, 82]), while prepregnancy diabetes had a large but similar impact. Similarly, the RR for GDM of having a large-relative to a normal-weight-for-gestational-age infant was lower in NHW (RR 1.41 [95% CI 1.34, 1.49]) than in NHB (RR 2.24 [95% CI 2.05, 2.46]). Conclusions/interpretation These data suggest that the negative effects of GDM combined with obesity during pregnancy may be greater in NHB than in NHW individuals. © 2012 Springer-Verlag.