The Association between Body Mass Index and Gestational Diabetes Mellitus Varies by Race/Ethnicity
Open accessAbstract
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/m (2) 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.
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The prevalence of gestational diabetes mellitus was highest among Asian women with BMI ≥30 kg/m2 (13.78%), followed by BMI ≥25 kg/m2 (10.22%) and BMI ≥20 kg/m2 (6.09%).
“prevalence of GDM was highest among Asian women with BMI ≥ 30 kg/m2 (13.78%), followed by BMI ≥ 25 kg/m2 (10.22%) and BMI ≥ 20 kg/m2 (6.09%).”
From Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis (2018) · cites this paper as [170]
The Results (page unavailable) say Asian women had the highest GDM rate within each BMI category, and the Discussion says GDM prevalence increased with prepregnancy BMI. Our copy does not give the claimed 13.78%, 10.22%, or 6.09% figures. It also describes separate BMI categories rather than the cumulative ≥30, ≥25, and ≥20 groups stated in the claim. (LLM, conf=0.85)
Experimental — accuracy not yet measuredA BMI ≥25 kg/m2 has a lower sensitivity (24.9%) but a good specificity (88.7%) compared with a BMI ≥21 kg/m2 cut-off, which has a higher sensitivity (68.4%) but a lower specificity (53.6%).
“A BMI ≥ 25 kg/m2 has a lower sensitivity (24.9%) but a good specificity (88.7%) in comparison to using a cut-off level of BMI ≥ 21 kg/m2 which has a higher sensitivity of 68.4% but a lower specificity of 53.6% [170].”
From Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis (2018) · cites this paper as [170]
The Results report all four sensitivity and specificity figures for Asian women with gestational diabetes. The citing sentence omits that population qualifier, making the figures appear applicable to pregnant women generally, whereas the paper shows that screening performance varies substantially by race/ethnicity. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe prevalence of gestational diabetes mellitus increases with increasing pre-pregnancy BMI.
“Prevalence of GDM is also increased with increasing pre-pregnancy BMI [170].”
From Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis (2018) · cites this paper as [170]
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Association of Body Mass Index with Gestational Diabetes Mellitus—an Indian Viewpoint
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- Authors
- Shah, A., Stotland, N., Cheng, Y., Ramos, G., & Caughey, A.
- Affiliations
- University of California, Los Angeles (US)
- University of California, San Francisco (US)
- University of California San Diego (US)
- Oregon Health & Science University (US)
- Venue
- American Journal of Perinatology
- Publisher
- Georg Thieme Verlag KG
- Published
- 2011-03-14
- Volume
- 28
- Issue
- 07
- Pages
- 515-520
- ISSN
- 0735-1631 (ISSN-L)
- 1098-8785
- PMC
- PMC3666587
- OpenAlex
- W2085619062
- Cited by
- 81
- References
- 25
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 5 · 2023: 6 · 2022: 13 · 2021: 6 · 2020: 8 · 2019: 7 · 2018: 6 · 2017: 4 · 2016: 2 · 2015: 4 · 2014: 3 · 2013: 6 · 2012: 4
- FWCI
- 5.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Perinatology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD01262, K12HD001262)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- gestational diabetes mellitus, body mass index, diabetes screening, racial and ethnic disparities, African American women, Hispanic women, Asian women, Caucasians, screening sensitivity and specificity, maternal obesity
- MeSH terms
- Adult, Asian, Black or African American, California, Female, Hispanic or Latino, Humans, Pregnancy, Retrospective Studies, ROC Curve, Body Mass Index, Multivariate Analysis, Chi-Square Distribution, Diabetes, Gestational, White People
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