Outcome of Pregnancy Among Immigrant Women With Diabetes

Abstract

OBJECTIVE—We studied outcome of pregnancy among immigrant women with diabetes. The women came from regions of the world with high incidence of impaired glucose tolerance and type 2 diabetes. Prevalences, secular trends, and sociodemographic risk factors of diabetes were also explored. RESEARCH DESIGN AND METHODS—Data from the Medical Birth Registry of Norway on all births from 1988 to 1998 for mothers born in South Asia and North Africa (11,268) and Norway (601,785) were analyzed. RESULTS—The prevalence of pregestational diabetes among the immigrants was 8.9/1,000 births, which was more than twice the rate among ethnic Norwegians (3.6/1,000). Time trends indicated increasing prevalences in both groups. Among the immigrants, diabetes was closely associated with maternal age. Maternal diabetes was associated with a significantly increased risk of pregnancy complications in both study groups. Increased risks were found for low birth weight, macrosomia, preterm birth, preeclampsia, and cesarean sections. Among ethnic Norwegians, maternal diabetes conferred a significantly increased risk of infant perinatal death (odds ratio 2.00, 95% CI 1,44–2.77). In the sample of immigrant women with predominantly type 2 diabetes, maternal diabetes was not significantly associated with perinatal death or congenital malformations in the offspring. CONCLUSIONS—The high prevalence of diabetes among immigrants from South Asia and North Africa represents a challenge for health care providers. To prevent adverse pregnancy outcomes and later cardiovascular and renal morbidity among these groups, early diagnosis of diabetes, adequate metabolic control, and relevant preventive measures are warranted.

Pregnancy Outcome in Type 2 Diabetes Mellitus: A Retrospective Analysis from the Netherlands

“…The relatively small sample precluded a detailed statistical analysis comparing Caucasian and nonCaucasian groups. The study by Vanger et al carried out in Denmark reported higher incidences of adverse outcome in the non-Caucasian women, but these differences were not statistically significant in the small groups [24].…”

Sociocultural factors that affect pregnancy outcomes in two Dissimilar Immigrant Groups in the United States

“…Diabetes depending on the type and severity increases the risk of adverse birth outcomes such as macrosomatia, low birth weight, prematurity, fetal death, and congenital anomalies. 22,35 In general, more severe stages of diabetes are associated with vascular compromise and smaller than expected birth weights. In a study of pregnancy outcomes among South Asian women in Norway, the prevalence of pregestational diabetes was almost twice as high as in Norwegians.…”

Grossesse et diabète de type 2 : quel pronostic fœtal ?

“…Elles sont plus âgées et plus en surpoids. Elles sont également plus souvent issues de l'immigration comme cela a été rapporté par Vangen [10] et de conditions socioéconomiques défavorables. Elles cumulent donc, outre le diabète lui-même, des facteurs de risque périnatal.…”