[Gestational diabetes mellitus and maternal ethnicity: high prevalence of fetal macrosomia in non-Caucasian women].

BACKGROUND AND OBJECTIVE: Differences in perinatal outcomes according to ethnicity have been described in pregnant women with gestational diabetes mellitus (GDM). We analysed the relationship between ethnicity, maternal characteristics and perinatal outcomes in pregnant women with GDM.

PATIENTS AND METHODS: Retrospective analysis of women with GDM attended at the centre between 1986 and 2007. We studied 2,543 mother-infant pairs (8.9% multiple pregnancies, 2,480 Caucasian [C] and 63 non-Caucasian [NC] mothers). Maternal characteristics and perinatal outcomes were compared according to maternal ethnicity and multivariable logistic regression analyses (backward method) were performed to predict perinatal outcomes.

RESULTS: The groups (C vs NC) differed in previous pregnancies, obstetric history, pregestational body mass index, delay between diagnosis and clinic entry, fasting plasma glucose at diagnosis and both initial and third trimester glycated hemoglobin, with all of them being worse in NC group. As to perinatal outcomes, we also observed differences in the prevalence of macrosomic (4.3 vs 19.4%) and large for gestational age newborns (LGA) (9.5 vs 32.3%), all of them being higher in the NC group. In the logistic regression analyses, NC was an independent predictor of macrosomia, LGA and jaundice with odds ratio ranging from 2.767 (95% confidence interval [95% CI] 1.257-6.091) for LGA and 3.629 (95% CI 0.972-13.548) for neonatal jaundice.

CONCLUSIONS: NC-GDM patients had more adverse perinatal outcomes only partially explained by medical history, anthropometric data and maternal glycemic control. NC ethnicity was an independent predictor of poor perinatal outcomes.