Racial/Ethnic Disparities in the Prevalence of Gestational Diabetes by BMI

OBJECTIVE d To examine whether the association between gestational diabetes mellitus (GDM) and BMI category varies by racial/ethnic group. RESEARCH DESIGN AND METHODS d In a cohort of 123,040 women without recognized pregravid diabetes who delivered babies between 1995 and 2006 at Kaiser Permanente of Northern California, we examined racial/ethnic disparities in the prevalence of GDM by BMI category and the population-attributable risk (PAR) associated with overweight/obesity. RESULTS d Among all racial/ethnic groups, the age-adjusted prevalence of GDM increased with increasing BMI (kg/m 2 ) category. However, Asian and Filipina women had a prevalence of GDM of 9.9 and 8.5%, respectively, at a BMI of 22.0 – 24.9 kg/m 2 , whereas in Hispanic, non-Hispanic white, and African American women, the prevalence of GDM was . 8.0% at a higher BMI, such as 28 – 30, 34 – 36, and $ 37 kg/m 2 , respectively. The estimated PARs suggest that the percentage of GDM that could be prevented if all pregnant women were of normal weight (BMI , 25.0 kg/m 2 )ranging from 65%for African Americanwomento only 23% among Asianwomen. CONCLUSIONS d Clinicians should be aware that the BMI thresholds for increased risk of GDM varies by racial/ethnic group and that the risk is high even at relatively low BMI cutoffs in Asian and Filipina women. Asian women may bene fi t from different prevention strategies in addition to weight management.