Background: Asian individuals are among the highest immigrant group to the US and at particularly high risk of gestational diabetes, which is associated with long-term maternal cardiovascular disease. Limited data are available on the association of pre-pregnancy cardiometabolic risk factors with gestational diabetes among Asian Americans.

Objectives: To determine the association of pre-pregnancy hypertension and BMI among Asian ancestry subgroups, and by maternal nativity.

Methods: Using data from the National Vital Statistics System from 2016-2019, the prevalence of gestational diabetes, stratified by pre-pregnancy hypertension and obesity, was examined by maternal race. Predicted probability of gestational diabetes with continuous BMI was calculated across Asian ancestry subgroups and by maternal nativity.

Results: Among 13.3M pregnancies, gestational diabetes occurred in 6.5%. Asians had the highest prevalence (12.3%). Among those with pre-pregnancy hypertension, Asians had the highest prevalence (29.3%). Across the range of BMI (18-42 kg/m²), Asians had the highest predicted probability. There was substantial heterogeneity across Asian ancestry subgroups between the association of BMI with gestational diabetes, with highest probability among Japanese and Korean Americans at BMI >23 kg/m². Predicted probability of gestational diabetes was higher for mothers born outside the US among all Asian subgroups, except for Japanese Americans.

Conclusions: Asian Americans have the highest prevalence of gestational diabetes at any BMI and with hypertension. Substantial variation in risk is present across Asian subgroups. Findings suggest a need for more tailored screening and intervention for gestational diabetes among Asian Americans with a specific focus on risk for individuals born outside the US.

JACC: Asia Editor-in-Chief 

Jian’an Wang, MD, PhD, FACC

CME Editor 

Kenneth A. Ellenbogen, MD

Author
Dustin Hillerson, MD, FACC

Important Dates

Date of Release: November 5, 2024
Term of Approval/Date of CME/MOC Expiration: November 4, 2025