Gestational diabetes mellitus among Sub-Saharan African and Surinamese women in the Netherlands. (October 2020)

• Record Type: Journal Article
• Authors: Rademaker, D.; van Schaijik, C.I.; Oostvogels, A.J.J.M.; van Rijn, B.B.; Evers, I.; DeVries, J.H.; Agyemang, C.; Vrijkotte, T.G.M.; Painter, R.C.
• Is Part Of: Diabetes research and clinical practice. Volume 168(2020)
• Publication Date: 2020-10
• Subjects: Gestational diabetes mellitus -- Ethnicity -- Risk-factors -- Pregnancy; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2020.108367
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Five to sevenfold higher risk of GDM in Ghanaian and other Sub-Saharan African women compared to ethnic Dutch women. Higher risk of GDM in Surinamese women compared to ethnic Dutch women. High-risk ethnicities currently not included in European guidelines. Abstract: Aim: We assessed the association between ethnicity and the risk of gestational diabetes mellitus (GDM) in the Netherlands. Methods: A cohort of 7815 women with known GDM status and ethnicity, including women of Sub-Saharan African ethnicity who are currently not identified as high-risk in guidelines. We compared GDM rates among participants of ethnicity to those of ethnic Dutch participants. We employed multivariable regression to correct for possible confounders, including maternal age, pre-pregnancy body mass index (BMI), and education. GDM prevalence and odds ratios based on ethnicity were the main outcome measures. Results: The prevalence rates of GDM according to ethnicity were: Dutch 0.6%, South-Asian Surinamese 6.9%, African-Surinamese 3.5%, Antillean 1.0%, Turkish 1.0%, Moroccan 1.4%, Ghanaian 6.8%, Sub-Saharan African 3.5%, other Western 0.5% and other non-Western 2.8%. After adjustment for age, pre-pregnancy BMI, and education duration, compared with the reference Dutch-ethnicity population, adjusted odds ratios (aOR) for GDM were statistically significantly higher in South-Asian Surinamese (aOR 10.9; 95% Confidence Interval (CI), 4.7–25.0), African-Surinamese (4.3; 2.0–9.2), Ghanaian (6.5; 3.0–14.5), Sub-Saharan African (5.7; 2.0–16.0), and other non-Western women (4.5; 2.2–9.0). GDM was not significantly increased among Antillean (1.4; 0.2–10.3), Turkish (1.4; 0.4–4.2), Moroccan (1.8; 0.8–4.0), and other Western women (0.8; 0.3–2.2). Conclusions: This study shows for the first time in the Netherlands that women of Ghanaian or other Sub-Saharan African ethnicity have an increased risk of developing GDM than the Dutch. This calls for adaptation of the Dutch guidelines of screening high-risk groups for GDM and more awareness amongst obstetric caregivers.