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DOI: 10.1055/s-0031-1272968
The Association between Body Mass Index and Gestational Diabetes Mellitus Varies by Race/Ethnicity
Publication History
Publication Date:
14 March 2011 (online)
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ABSTRACT
We examined body mass index (BMI) as a screening tool for gestational diabetes (GDM) and its sensitivity among different racial/ethnic groups. In a retrospective cohort study of 24,324 pregnant women at University of California, San Francisco, BMI was explored as a screening tool for GDM and was stratified by race/ethnicity. Sensitivity and specificity were examined using chi-square test and receiver-operator characteristic curves. BMI of ≥25.0 kg/m2 as a screening threshold identified GDM in >76% of African-Americans, 58% of Latinas, and 46% of Caucasians, but only 25% of Asians (p < 0.001). Controlling for confounders and comparing to a BMI of ≤25, African-Americans had the greatest increased risk of GDM (adjusted odds ratio [AOR] 5.1, 95% confidence interval [CI]: 3.0 to 8.5), followed by Caucasians (AOR 3.6, 95% CI: 2.7 to 4.8), Latinas (AOR 2.7, 95% CI: 1.9 to 3.8), and Asians (AOR 2.3, 95% CI: 1.8 to 3.0). BMI's screening characteristics to predict GDM varied by race/ethnicity. BMI can be used to counsel regarding the risk of developing GDM, but alone it is not a good screening tool.
KEYWORDS
Body mass index - gestational diabetes mellitus - glucose loading test - race/ethnicity - receiver-operator characteristic curve
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Aaron B CaugheyM.D. Ph.D.
Department of Obstetrics and Gynecology, Oregon Health and Science University
3181 S.W. Sam Jackson, Portland, OR 97239-3098
Email: abcmd@berkeley.edu