Resumo

RODRIGUES, Inês Morais et al. Ethnicity/racial impact in gestational diabetes mellitus. Acta Obstet Ginecol Port [online]. 2019, vol.13, n.2, pp.72-80. ISSN 1646-5830.

Overview and Aims: Gestational diabetes (GD) is associated with increased risk for pregnancy and delivery complications. Ethnicity is a recognized risk factor for GD. Considering ethnic diversity in Portugal, it is important that health providers are familiar with differences in expected outcomes. This study was designed to compare Asian, Black and Caucasian women with GD. Study Design: Observational, retrospective study. Population: Women with singleton pregnancies and GD followed in our hospital, from 2012 to 2015. Materials and Methods: 323 women were divided according to country of birth and skin color - Caucasian (G1, n=230), Black (G2, n=79) and Asian (G3, n=14). Demographic characteristics, risk factors for GD and previous hypertension were compared. Maternal/fetal outcomes were analyzed - maternal weight gain, metabolic control, need of pharmacologic therapy, hypertensive complications, ultrasound biometric measures, intrauterine demise, mode of delivery, newborn weight and comorbidities. X2 and Fisher tests were performed. Significance was set at p-value<0.05. Results: G1 included women mainly from Portugal, G2 from Guinea Bissau, Angola and Portugal and G3 from India. Groups differed in level of education (p=0.023) and Body Mass Index categories (p=0.034) - G2 had the lowest level of education and the highest rates of overweight/obesity. Statistical difference was found in metabolic control, resulting in glycated haemoglobin below 6% (p=0.022) and mode of delivery (p<0,001); G2 and G3 had worse metabolic control than G1, with higher C-section rates. Neonatal comorbidity differed between groups (p=0.021), with G2 having higher rates, mainly hyperbilirrubinemia requiring phototherapy. Need or type of pharmacologic therapy (insulin/metformin) showed no difference between groups. Conclusions: Metabolic control in Asian and Black women with GD was more difficult to achieve than in Caucasians, with afterwards worse maternal/fetal outcomes. Health providers should acknowledge differences between ethnicities and a multidisciplinary and individualized approach should be provided.

Palavras-chave : Gestational diabetes mellitus; Ethnicity; Race.

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