Impact of family income on the development of gestational diabetes mellitus and the associated birth outcomes: A nationwide study

• Published in: Journal of diabetes investigation 2025-01, Vol.16 (1), p.51-59
• Main Authors: Yen, Fu‐Shun, Wei, James Cheng‐Chung, Wu, Yi‐Ling, Lo, Yu‐Ru, Chen, Chih‐Ming, Hwu, Chii‐Min, Hsu, Chih‐Cheng
• Format: Article
• Language: English
• Subjects: Adult; Alcohol; Birth; Birth outcomes; Comorbidity; Congenital defects; Diabetes mellitus; Diabetes, Gestational - epidemiology; Encephalopathy; Families & family life; Family income; Family medical history; Female; Gestational age; Gestational diabetes; Gestational diabetes mellitus; Health care policy; Health insurance; Humans; Hyperglycemia; Hypertension; Hypoxia; Income - statistics & numerical data; Infant, Newborn; Insulin resistance; Ischemia; Jaundice; Lupus; Mental depression; Metabolic disorders; Multiple births; Neonates; Obesity; Original; Ovaries; Phototherapy; Polycystic ovary syndrome; Preeclampsia; Pregnancy; Pregnancy complications; Pregnancy Outcome - epidemiology; Premature birth; Rheumatoid arthritis; Risk Factors; Small for gestational age; Special Issue; Steroids; Taiwan - epidemiology; Womens health
• ISSN: 2040-1116; 2040-1124; 2040-1124
• DOI: 10.1111/jdi.14288

ABSTRACT Aims/Introduction The relationship between economic disadvantages and the risk of developing gestational diabetes mellitus (GDM), as well as its impact on birth outcomes, remains uncertain. Materials and Methods From the Taiwan Maternal and Child Health Database, we identified 984,712 pregnant women between 1 January 2007 and 31 December 2018. Using propensity score matching, we selected 5,068 pairs of women across four income levels: very low, low, middle and high. We used a multivariable Cox regression model to assess the risk of GDM in these pregnant women and analyzed the birth outcomes. Results The mean age of the pregnant women was 30.89 years. We found no significant difference in GDM risk among pregnant women with different family income. However, newborns of women with GDM and very low‐income were at higher risk for several adverse conditions, such as small for gestational age (adjusted odds ratio (aOR) 1.17, 95% confidence interval (CI) 1.04–1.31), large for gestational age (aOR 1.27, 95% CI 1.08–1.51), hypoxic–ischemic encephalopathy (aOR 3.19, 95% CI 1.15–8.86), respiratory distress (aOR 1.58, 95% CI 1.14–2. 19), congenital anomalies (aOR 1.32, 95% CI 1.08–1.62), jaundice requiring phototherapy or exchange transfusion (aOR 1.14, 95% CI 1.05–1.24) and so on. Conclusions This study found that low family income alone was not associated with GDM development. However, for a GDM pregnancy, pregnant women with lower income had worse birth outcomes. Improving maternal health and nutrition among low‐income pregnant women with GDM might be critical to improving birth outcomes. Low family income alone was not associated with gestational diabetes mellitus development. However, for a gestational diabetes mellitus pregnancy, pregnant women with lower income had worse birth outcomes. Improving maternal health and nutrition among low‐income pregnant women with gestational diabetes mellitus might be critical to improving birth outcomes.