Risk and adverse outcomes of gestational diabetes in migrants: A population cohort study

•Women migrant to western European countries are at higher risk of GDM.•Ethnicity increases the risk of adverse outcomes commonly associated to GDM.•Adding GDM and ethnicity in predictive models reversed the risk of adverse outcomes.•Targeting GDM is associated, in migrants, with a global reduction...

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Published in:Diabetes research and clinical practice 2020-05, Vol.163, p.108128-108128, Article 108128
Main Authors: Seghieri, Giuseppe, Di Cianni, Graziano, Seghieri, Marta, Lacaria, Emilia, Corsi, Edoardo, Lencioni, Cristina, Gualdani, Elisa, Voller, Fabio, Francesconi, Paolo
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Language:English
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Cohort study
Gestational diabetes
Maternal complications
Migrants
Neonatal complications
Singleton live births
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container_title Diabetes research and clinical practice
container_volume 163
creator Seghieri, Giuseppe
Di Cianni, Graziano
Seghieri, Marta
Lacaria, Emilia
Corsi, Edoardo
Lencioni, Cristina
Gualdani, Elisa
Voller, Fabio
Francesconi, Paolo
description •Women migrant to western European countries are at higher risk of GDM.•Ethnicity increases the risk of adverse outcomes commonly associated to GDM.•Adding GDM and ethnicity in predictive models reversed the risk of adverse outcomes.•Targeting GDM is associated, in migrants, with a global reduction in adverse outcomes. To evaluate the risk of gestational diabetes (GDM) and of neonatal/maternal complications (macrosomia, large for gestational age (LGA), cesarean sections, preterm deliveries, neonatal distress and fetal malformations) among women coming from High Migration Pressure Countries (HMPC), compared to native (Italian) mothers. Risks of GDM and related neonatal/maternal complications were evaluated in a cohort of 581,073 Italian compared with 105,111 HMPC women of age 15–45 yr, resident in Tuscany, Italy along years 2012–2017, delivering 122,652 singleton live births (18,596 from HMPC mothers). HMPC women, compared to Italian ones, were at higher risk of GDM (OR: 1.586; 1.509–1.666;p 
doi_str_mv 10.1016/j.diabres.2020.108128
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To evaluate the risk of gestational diabetes (GDM) and of neonatal/maternal complications (macrosomia, large for gestational age (LGA), cesarean sections, preterm deliveries, neonatal distress and fetal malformations) among women coming from High Migration Pressure Countries (HMPC), compared to native (Italian) mothers. Risks of GDM and related neonatal/maternal complications were evaluated in a cohort of 581,073 Italian compared with 105,111 HMPC women of age 15–45 yr, resident in Tuscany, Italy along years 2012–2017, delivering 122,652 singleton live births (18,596 from HMPC mothers). HMPC women, compared to Italian ones, were at higher risk of GDM (OR: 1.586; 1.509–1.666;p &lt; 0.0001), peaking for women originating from South Asia (OR:3.0.49; 2.618–3.553;p &lt; 0.0001). GDM was associated with increased risk of preterm delivery and cesarean sections, while migrants, regardless of GDM, were burdened by a higher risk of all considered complications. The rise in all these risks, including macrosomia or LGA however, disappeared, after addition of interaction term GDM × HMPC ethnicity. Compared to Italian mothers, HMPC women had higher risk of GDM and of all considered adverse events. The addiction of the interaction term GDM × HMPC ethnicity in the predictive model, however reversed the rise in risk of all HMPC associated adverse outcomes.</description><identifier>ISSN: 0168-8227</identifier><identifier>EISSN: 1872-8227</identifier><identifier>DOI: 10.1016/j.diabres.2020.108128</identifier><identifier>PMID: 32259610</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Cohort study ; Gestational diabetes ; Maternal complications ; Migrants ; Neonatal complications ; Singleton live births</subject><ispartof>Diabetes research and clinical practice, 2020-05, Vol.163, p.108128-108128, Article 108128</ispartof><rights>2020 Elsevier B.V.</rights><rights>Copyright © 2020 Elsevier B.V. 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To evaluate the risk of gestational diabetes (GDM) and of neonatal/maternal complications (macrosomia, large for gestational age (LGA), cesarean sections, preterm deliveries, neonatal distress and fetal malformations) among women coming from High Migration Pressure Countries (HMPC), compared to native (Italian) mothers. Risks of GDM and related neonatal/maternal complications were evaluated in a cohort of 581,073 Italian compared with 105,111 HMPC women of age 15–45 yr, resident in Tuscany, Italy along years 2012–2017, delivering 122,652 singleton live births (18,596 from HMPC mothers). HMPC women, compared to Italian ones, were at higher risk of GDM (OR: 1.586; 1.509–1.666;p &lt; 0.0001), peaking for women originating from South Asia (OR:3.0.49; 2.618–3.553;p &lt; 0.0001). GDM was associated with increased risk of preterm delivery and cesarean sections, while migrants, regardless of GDM, were burdened by a higher risk of all considered complications. The rise in all these risks, including macrosomia or LGA however, disappeared, after addition of interaction term GDM × HMPC ethnicity. Compared to Italian mothers, HMPC women had higher risk of GDM and of all considered adverse events. 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To evaluate the risk of gestational diabetes (GDM) and of neonatal/maternal complications (macrosomia, large for gestational age (LGA), cesarean sections, preterm deliveries, neonatal distress and fetal malformations) among women coming from High Migration Pressure Countries (HMPC), compared to native (Italian) mothers. Risks of GDM and related neonatal/maternal complications were evaluated in a cohort of 581,073 Italian compared with 105,111 HMPC women of age 15–45 yr, resident in Tuscany, Italy along years 2012–2017, delivering 122,652 singleton live births (18,596 from HMPC mothers). HMPC women, compared to Italian ones, were at higher risk of GDM (OR: 1.586; 1.509–1.666;p &lt; 0.0001), peaking for women originating from South Asia (OR:3.0.49; 2.618–3.553;p &lt; 0.0001). GDM was associated with increased risk of preterm delivery and cesarean sections, while migrants, regardless of GDM, were burdened by a higher risk of all considered complications. 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subjects Cohort study
Gestational diabetes
Maternal complications
Migrants
Neonatal complications
Singleton live births
title Risk and adverse outcomes of gestational diabetes in migrants: A population cohort study
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