Psychosocial, Behavioral, and Medical Drivers of Gestational Diabetes among Racial-Ethnic Groups
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Abstract Certain racial and ethnic groups have historically been labeled “high-risk” for the development of gestational diabetes mellitus (GDM). Our objective was to identify the psychosocial, behavioral, and medical factors associated with GDM and determine if they differ by race/ethnicity. Secondary analysis of a multicenter, prospective cohort study of pregnant nulliparous individuals with singleton gestations (2010–2013). The primary outcome was GDM. Psychosocial, behavioral, and medical characteristics were compared by self-reported race/ethnicity. Multivariable logistic regression with backward selection identified factors associated with GDM. Interaction terms between race/ethnicity and risk factors were tested. Of 8,672 pregnant individuals, 61% were non-Hispanic White, 13% non-Hispanic Black, 17% Hispanic, 4% Asian, and 5% other. The incidence of GDM differed by race/ethnicity with 4% non-Hispanic White, 3% non-Hispanic Black, 5% Hispanic, 11% Asian, and 5% other (p < 0.001). Of 34 psychosocial, behavioral, and medical factors, those associated with GDM were parent with history of diabetes (adjusted odds ratio [aOR]: 1.72; 95% confidence interval [CI]: 1.33–2.23), non-English language (aOR: 2.57; 95% CI: 1.14–5.79), daily calorie intake (aOR: 1.18; 95% CI: 1.08–1.29), daily fiber intake (aOR: 0.84; 95% CI: 0.75–0.94), maternal age (aOR: 1.53; 95% CI: 1.37–1.70), prepregnancy BMI (aOR: 1.21; 95% CI: 1.02–1.44), and waist circumference (aOR: 1.21; 95% CI: 1.03–1.43). These associations did not differ based on race/ethnicity (interaction p-values > 0.1). Replacing race/ethnicity as a risk factor for GDM with significant upstream psychosocial, behavioral, and medical factors should be considered.
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A range of socio-demographic, obstetric and metabolic factors have been identified as contributing to the risk of GDM, including age, body mass index (BMI) and ethnicity.
“A range of socio‐demographic, obstetric and metabolic factors have been identified as contributing to the risk of GDM, including age, body mass index (BMI) and ethnicity [3, 4].”
From Preconception Perceptions, Knowledge and Behaviours of Women With Gestational Diabetes Mellitus: A Qualitative Study (2026) · cites this paper as [3]
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Cites
A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807 · see citing works
Detection of Postnatal Depression: Development of the 10-item Edinburgh Postnatal Depression Scale
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987) · British Journal of Psychiatry · doi:10.1192/bjp.150.6.782 · Cited by 14,183 · see citing works
Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC)
Connor, K. M., & Davidson, J. R. T. (2003) · Depression and Anxiety · doi:10.1002/da.10113 · Cited by 11,793 · see citing works
IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045
Cho, N. H., Shaw, J. E., Karuranga, S., Huang, Y., da Rocha Fernandes, J. D., Ohlrogge, A. W., & Malanda, B. (2018) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2018.02.023 · Cited by 7,283 · see citing works
Hyperglycemia and adverse pregnancy outcomes
(2008) · New England Journal of Medicine · doi:10.1056/nejmoa0707943 · Cited by 5,563 · see citing works
Psychometric Characteristics of the Multidimensional Scale of Perceived Social Support
Zimet, G. D., Powell, S. S., Farley, G. K., Werkman, S., & Berkoff, K. A. (1990) · Journal of Personality Assessment · doi:10.1080/00223891.1990.9674095 · Cited by 4,855 · see citing works
2. Classification and Diagnosis of Diabetes: Standards of Care in Diabetes—2023
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Gaglia, J. L., Hilliard, M. E., Isaacs, D. M., et al. (2022) · Diabetes Care · doi:10.2337/dc23-s002 · Cited by 2,652 · see citing works
The Pathophysiology of Gestational Diabetes Mellitus
Plows, J. F., Stanley, J. L., Baker, P. N., Reynolds, C. M., & Vickers, M. H. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19113342 · Cited by 1,874 · see citing works
ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus
(2018) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000002501 · Cited by 1,820 · see citing works
Krieger, N., Smith, K., Naishadham, D., Hartman, C., & Barbeau, E. M. (2005) · Social Science & Medicine · doi:10.1016/j.socscimed.2005.03.006 · Cited by 1,704 · see citing works
Prevalence of Gestational Diabetes and Risk of Progression to Type 2 Diabetes: a Global Perspective
Zhu, Y., & Zhang, C. (2016) · Current Diabetes Reports · doi:10.1007/s11892-015-0699-x · Cited by 1,260 · see citing works
Vounzoulaki, E., Khunti, K., Abner, S. C., Tan, B. K., Davies, M. J., & Gillies, C. L. (2020) · BMJ · doi:10.1136/bmj.m1361 · Cited by 1,150 · see citing works
Gestational Diabetes Mellitus and Macrosomia: A Literature Review
Kc, K., Shakya, S., & Zhang, H. (2015) · Annals of Nutrition and Metabolism · doi:10.1159/000371628 · Cited by 930 · see citing works
Guenther, P. M., Kirkpatrick, S. I., Reedy, J., Krebs‐Smith, S. M., Buckman, D. W., Dodd, K. W., Casavale, K. O., & Carroll, R. J. (2014) · Journal of Nutrition · doi:10.3945/jn.113.183079 · Cited by 824 · see citing works
Development and Validation of a Short-Form, Rapid Estimate of Adult Literacy in Medicine
Arozullah, A., Yarnold, P., Bennett, C., Soltysik, R., Wolf, M., Ferreira, R. M., Lee, S., Costello, S., Shakir, A., Denwood, C., et al. (2007) · Medical Care · doi:10.1097/mlr.0b013e3180616c1b · Cited by 434 · see citing works
Yogev, Y., Xenakis, E. M. J., & Langer, O. (2004) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2004.03.074 · Cited by 325 · see citing works
Haas, D. M., Parker, C. B., Wing, D. A., Parry, S. I., Grobman, W. A., Mercer, B. M., Simhan, H. N., Hoffman, M., Silver, R. M., Wadhwa, P. D., et al. (2015) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2015.01.019 · Cited by 307 · see citing works
The influence of obesity and diabetes on the risk of cesarean delivery
Ehrenberg, H. M., Durnwald, C. P., Catalano, P. M., & Mercer, B. M. (2004) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2004.06.057 · Cited by 275 · see citing works
Trends in Gestational Diabetes at First Live Birth by Race and Ethnicity in the US, 2011-2019.
Shah, N. S., Wang, M. C., Freaney, P., Perak, A., Carnethon, M., Kandula, N., Gunderson, E., Bullard, K., Grobman, W., O'Brien, M., et al. (2021) · Journal of the American Medical Association (JAMA) · doi:10.1001/jama.2021.7217 · Cited by 249 · see citing works
Risk factors for gestational diabetes: An umbrella review of meta-analyses of observational studies
Giannakou, K., Εvangelou, Ε., Yiallouros, P. K., Christophi, C. A., Middleton, N., Papatheodorou, E., & Papatheodorou, S. (2019) · PLoS ONE · doi:10.1371/journal.pone.0215372 · Cited by 195 · see citing works
Gilbert, L., Gross, J., Lanzi, S., Quansah, D. Y., Puder, J. J., & Horsch, A. (2019) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-019-2185-y · Cited by 170 · see citing works
Nahum Sacks, K., Friger, M., Shoham-Vardi, I., Abokaf, H., Spiegel, E., Sergienko, R., Landau, D., & Sheiner, E. (2016) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2016.03.030 · Cited by 165 · see citing works
Racial/Ethnic Differences in Gestational Diabetes Prevalence and Contribution of Common Risk Factors
Pu, J., Zhao, B.-N., Wang, E., Nimbal, V. C., Osmundson, S., Kunz, L., Popat, R., Chung, S., & Palaniappan, L. (2015) · Paediatric and Perinatal Epidemiology · doi:10.1111/ppe.12209 · Cited by 161 · see citing works
Gestational diabetes hinders language development in offspring
Dionne, G., Boivin, M., Séguin, J. R., Pérusse, D., & Tremblay, R. E. (2008) · Pediatrics · doi:10.1542/peds.2007-3028 · Cited by 136 · see citing works
Risk Factors and Management of Gestational Diabetes
Chen, P., Wang, S., Ji, J., Ge, A., Chen, C., Zhu, Y., Xie, N., & Wang, Y. (2014) · Cell Biochemistry and Biophysics · doi:10.1007/s12013-014-0248-2 · Cited by 119 · see citing works
Delanerolle, G., Phiri, P., Zeng, Y., Marston, K., Tempest, N., Busuulwa, P., Shetty, A., Goodison, W., Muniraman, H., Duffy, G., et al. (2021) · EClinicalMedicine · doi:10.1016/j.eclinm.2021.101016 · Cited by 53 · see citing works
Liu, B., Lamerato, L. E., & Misra, D. P. (2019) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2019.1566310 · Cited by 34 · see citing works
Danyliv, A., Gillespie, P., O’Neill, C., Noctor, E., O’Dea, A., Tierney, M., McGuire, B. E., Glynn, L. G., & Dunne, F. (2014) · Diabetic Medicine · doi:10.1111/dme.12678 · Cited by 34 · see citing works
Mishra, S., Shetty, A., Rao, C. R., Nayak, S., & Kamath, A. (2020) · Diabetes & Metabolic Syndrome Clinical Research & Reviews · doi:10.1016/j.dsx.2020.06.048 · Cited by 27 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- [22]Gandhi M, ACOG clinical practice update: screening for gestational and pregestational diabetes in pregnancy and postpartum. Obstet Gynecol 2024 42131962
- [32]Grobman WA, Executive summary: Workshop on social determinants of health and obstetrical outcomes, February 1–2, 2022, cosponsored by the Society for Maternal-Fetal Medicine, the Commonwealth Foundation, and the Alliance for Innovation on Maternal Health, with support from the Society for Women’s Health Research. SMFM STATEMENT. 2023 Mar; 223(3): PB18– B24 36473505
Cited by
Sorted by citations
Payne, E., Schoenaker, D., Turner, K., Murphy, H. R., Skouteris, H., Ismail, K., Silverio, S. A., & Benton, M. (2026) · Health Expectations · doi:10.1111/hex.70617 · Cited by 4 · see citing works
“A range of socio‐ demographic, obstetric and metabolic factors have been identified as contributing to the risk of GDM, including age, body mass index (BMI) and ethnicity [3, 4].”
Prashanthan, J., & Prashanthan, A. (2026) · Cureus · doi:10.7759/cureus.104782 · Cited by 2 · see citing works
- Authors
- Gardner, A. B., Champion, M. L., Janevic, T., Yee, L. M., & Battarbee, A. N.
- Affiliations
- University of Alabama at Birmingham (US)
- Columbia University (US)
- Northwestern University (US)
- Corresponding author
- Gardner, Austin B.
- Venue
- American Journal of Perinatology
- Publisher
- Georg Thieme Verlag KG
- Published
- 2025-03-29
- Volume
- 42
- Issue
- 15
- Pages
- 2024-2031
- ISSN
- 0735-1631 (ISSN-L)
- 1098-8785
- PMC
- PMC12228551
- OpenAlex
- W4408963805
- Cited by
- 1
- References
- 29
- Citations by year
- 2026: 1
- FWCI
- 1.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Perinatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK092949, P30DK079626)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- gestational diabetes mellitus, racial and ethnic disparities, risk factors, psychosocial factors, maternal diet, dietary fiber intake, maternal age, prepregnancy BMI, waist circumference, family history of diabetes, language barriers, nulliparous women, singleton pregnancy, maternal health equity
- MeSH terms
- White, Adult, Black or African American, Ethnicity, Female, Hispanic or Latino, Humans, Pregnancy, Prospective Studies, Risk Factors, United States, Body Mass Index, Incidence, Multivariate Analysis, Logistic Models, Diabetes, Gestational, White People, Racial Groups, Young Adult
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