Date of Award

1-10-2020

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Harry J. Heiman

Second Advisor

Brian Barger

Third Advisor

Ike S. Okosun

Abstract

ABSTRACT

Examining the Risk and Prevalence of Gestational Diabetes Mellitus

Among Hispanic Population Subgroups in the United States

By

Natalie Elizabeth Tripp

December 13th, 2019

INTRODUCTION: Gestational diabetes mellitus (GDM) is a significant public health problem in the United States because of its implications for both maternal and child health. While it is well documented that Hispanic women are disproportionately impacted by GDM, research and surveillance about GDM among ethnic subgroups is limited. Understanding how racial and ethnic subgroups differ from the general population, and from each other, have important research, policy, prevention and treatment implications.

AIM: This project will determine which Hispanic subgroups in the U.S. have the highest prevalence of GDM and if the associated risk factors for GDM vary among different Hispanic subgroups.

METHODS: Data from the National Vital Statistics System were analyzed using R version 3.5. Vital birth statistics from 2017 were used to determine prevalence rates among Hispanic subgroups. Hispanic group-specific multiple logistic regression analyses were used to test and compare factors associated with GDM.

RESULTS: Among the Hispanic subgroups analyzed, Mexican American women (7.4%) had the highest prevalence of GDM, compared to Central/South Americans (6.5%), Puerto Ricans Americans (6.5%) and Cuban Americans (5.7%). In multivariable models, the risk factors showing greatest variation for GDM among Hispanic ethnic subgroups were maternal age (being 25 years or older), BMI (having an overweight/obese BMI), and nativity (being born outside the U.S.).

CONCLUSION: Maternal age, BMI, and nativity were most strongly, and positively, associated with GDM status among women in all Hispanic subgroups. Nativity is of particular importance, as being born outside of the U.S. has traditionally been recognized as a protective factor against many chronic illnesses. Given that there are higher percentages of Hispanic women having babies who are foreign-born, researchers should strive to promote recruitment and inclusion of minority populations in health research to better inform prevention and treatment programs, and reduce the need to consolidate subgroups for statistical analysis. Ultimately, identifying at-risk populations though subgroup analysis may lead to reductions in disease prevalence and improvements in maternal and child health outcomes.

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