Preterm birth and nativity among Black women with gestational diabetes in California, 2013-2017: a population-based retrospective cohort study

Karen A Scott; Brittany D Chambers; Rebecca J Baer; Kelli K Ryckman; Monica R McLemore; Laura L Jelliffe-Pawlowski

doi:10.1186/s12884-020-03290-3

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Preterm birth and nativity among Black women with gestational diabetes in California, 2013-2017: a population-based retrospective cohort study

Journal article

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Peer reviewed

Preterm birth and nativity among Black women with gestational diabetes in California, 2013-2017: a population-based retrospective cohort study

Karen A Scott, Brittany D Chambers, Rebecca J Baer, Kelli K Ryckman, Monica R McLemore and Laura L Jelliffe-Pawlowski

BMC pregnancy and childbirth, Vol.20(1), pp.593-593

10/06/2020

DOI: 10.1186/s12884-020-03290-3

PMCID: PMC7541301

PMID: 33023524

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Abstract

Despite the disproportionate prevalence of gestational diabetes (GDM) and preterm birth (PTB) and their associated adverse perinatal outcomes among Black women, little is known about PTB among Black women with GDM. Specifically, the relationship between PTB by subtype (defined as indicated PTB and spontaneous PT labor) and severity, GDM, and nativity has not been well characterized. Here we examine the risk of PTB by severity (early < 34 weeks, late 34 to 36 weeks) and early term birth (37 to 38 weeks) by nativity among Black women with GDM in California. This retrospective cohort study used linked birth certificate and hospital discharge data for 8609 of the 100,691 self-identifying non-Hispanic Black women with GDM who had a singleton live birth between 20 and 44 weeks gestation in California in 2013-2017. Adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were examine risks for PTB, by severity and subtype, and early term birth using multivariate regression modeling. Approximately, 83.9% of Black women with GDM were US-born and 16.1% were foreign-born. The overall prevalence of early PTB, late PTB, and early term birth was 3.8, 9.5, and 29.9%, respectively. Excluding history of prior PTB, preeclampsia was the greatest overall risk factor for early PTB (cOR = 6.7, 95%, CI 5.3 to 8.3), late PTB (cOR = 4.3, 95%, CI 3.8 to 5.0), and early term birth (cOR = 1.8, 95%, CI 1.6 to 2.0). There was no significant difference in the prevalence of PTB by subtypes and nativity (p = 0.5963). Overall, 14.2% of US- compared to 8.9% of foreign-born women had a PTB (early PTB: aOR = 0.56, 95%, CI 0.38 to 0.82; late PTB: aOR = 0.57, 95%, CI 0.45 to 0.73; early term birth: aOR = 0.67, 95%, CI 0.58 to 0.77). Foreign-born status remained protective of PTB, irrespective of severity and subtype. Preeclampsia, PTB, and GDM share pathophysiologic mechanisms suggesting a need to better understand differences in perinatal stress, chronic disease, and vascular dysfunction based on nativity in future epidemiologic studies and health services research.

Adult

African Americans - ethnology

African Americans - statistics & numerical data

California

Diabetes, Gestational - diagnosis

Diabetes, Gestational - epidemiology

Diabetes, Gestational - ethnology

Emigrants and Immigrants - statistics & numerical data

Female

Gestational Age

Health Status Disparities

Humans

Infant, Newborn

Maternal Age

Pre-Eclampsia - epidemiology

Pregnancy

Premature Birth - epidemiology

Premature Birth - ethnology

Prevalence

Protective Factors

Retrospective Studies

Risk Factors

Severity of Illness Index

Young Adult

Details

Title: Subtitle: Preterm birth and nativity among Black women with gestational diabetes in California, 2013-2017: a population-based retrospective cohort study
Creators: Karen A Scott - Department of Obstetrics, Gynecology & Reproductive Sciences, School of Medicine, University of California San Francisco, 2356 Sutter Street, J-140, San Francisco, CA, 94143, USA. karen.scott2@ucsf.edu
Brittany D Chambers - Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, 560 16th Street, Second Floor, San Francisco, CA, 94158, USA
Rebecca J Baer - Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, Building 3, La Jolla, CA, 92161, USA
Kelli K Ryckman - Department of Epidemiology, University of Iowa College of Public Health, 145 N. Riverside Drive, Office S435 CPHB, Iowa City, IA, 52242, USA
Monica R McLemore - Family Health Care Nursing Department, School of Nursing, University of California, 2 Koret Way, N431H, San Francisco, San Francisco, CA, 94143, USA
Laura L Jelliffe-Pawlowski - Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, 560 16th Street, Second Floor, San Francisco, CA, 94158, USA
Resource Type: Journal article
Publication Details: BMC pregnancy and childbirth, Vol.20(1), pp.593-593
DOI: 10.1186/s12884-020-03290-3
PMID: 33023524
PMCID: PMC7541301
NLM abbreviation: BMC Pregnancy Childbirth
ISSN: 1471-2393
eISSN: 1471-2393
Grant note: [K12 HD052163] / NICHD/ORWH
Language: English
Date published: 10/06/2020
Academic Unit: Stead Family Department of Pediatrics; Epidemiology
Record Identifier: 9984214805402771

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