Influence of Acculturation on Risk for Gestational Diabetes Among Asian Women

INTRODUCTION: Asian women have a higher prevalence of gestational diabetes mellitus than women of other races/ethnicities. We aimed to compare the prevalence of gestational diabetes among Asian American women to other racial/ethnic groups and explore whether the higher occurrence of the disorder among Asian women can be explained by acculturation. METHODS: We conducted a population-based, cross-sectional study among 5,562 women who participated in the 2007 Los Angeles Mommy and Baby Study (LAMB) in Los Angeles County, California. All women included in this study had a live delivery in 2007 and did not have pre-pregnancy type I or II diabetes. We applied multivariate, weighted logistic regressions to compare gestational diabetes prevalence among racial/ethnic groups, adjusting for its known risk factors. We conducted mediation analysis to test whether the difference in prevalence across racial/ethnic groups could be explained by acculturation. RESULTS: Among the 5,562 women studied, the weighted prevalence of gestational diabetes was 15.5% among Asian American women, followed by 9.0% among non-Hispanic black women, 10.7% among Hispanic women, and 7.9% among non-Hispanic white women. Compared with non-Hispanic white women, Asian women had 2.44 (95% confidence interval [CI], 1.81–3.29; P < .001) times the odds of having gestational diabetes, independent of maternal age, education, marital status, income, prenatal care adequacy, prepregnancy BMI, and physical activity. Acculturation was negatively associated with having gestational diabetes (odds ratio [OR] = 0.93; 95% CI, 0.86–0.99) and explained 15.9% (95% CI, 11.38%–25.08%; P < .001) of the association between Asian race and the condition. CONCLUSION: We found that Asian race was an independent risk factor for gestational diabetes, and higher acculturation may play a protective role against it in Asian American women.