The prevalence of gestational diabetes among Micronesians in Honolulu.

OBJECTIVES: There is a high prevalence of type 2 diabetes among Micronesians leading to the assumption that they are at an increased risk for gestational diabetes. The objective of this study was to determine the prevalence of gestational diabetes among the Micronesian population in Honolulu, Hawai'i. Secondary objectives were to determine factors associated with gestational diabetes and compare maternal and fetal outcomes between the Micronesian gestational diabetic and non-diabetic populations.

METHODS: A retrospective chart review was performed of all delivery records from January 1997 to December 2006. Data were analyzed using measures of association and multiple logistic regression.

RESULTS: Of the 2966 charts reviewed, 2303 met inclusion criteria. The prevalence of gestational diabetes was 6.2% and the prevalence of type 2 diabetes was 0.8%. In comparison to the non-diabetic group, the gestational diabetic population was significantly older (p=0.002) and heavier (p<0.001). Micronesians with gestational diabetes had higher rates of cesarean section and hypertensive disorders. However, rates of shoulder dystocia were not statistically different. Infants of gestational diabetic mothers experienced higher rates of neonatal intensive care unit admission and hypoglycemia.

CONCLUSION: The prevalence of gestational diabetes in the Micronesian population is lower than expected given the high prevalence of obesity and type 2 diabetes among Micronesians. Those with gestational diabetes are at an increased risk for maternal and neonatal morbidity. Future public health endeavors should address increasing rates of obesity in the United States, specifically in Pacific Islander populations.