Introduction: Clinical studies have found disparities in gestational diabetes mellitus (GDM) outcomes due to individual racial and economic differences. In contrast, this pilot study examines the association of structures variations with GDM outcomes by race.

Methods: Data were obtained from a healthcare system for a study population of 2,189 women with GDM, 18 years and above, singleton births, who delivered between January 1, 2014 and December 31, 2018. Clinical data were merged with structural measures of mothers’ census tracts of residence from the U.S. Census Bureau. Outcome variables are mother and infant birth complications. Data are analyzed using zero correlations by race.

Results: Mother’s: white mothers tended to have fewer complications (r=-0.07, p<.05); not other races. For African American women, living in a tract with a higher % of households below the poverty level and higher % of less than $35K earners increased the likelihood of their experiencing Hemorrhage (r=0.11, p<0.03; r=0.12, p<0.05). For women of other races, living in a tract with higher percentage of household below the poverty level increased the likelihood of Hemorrhage (r=0.11, p<.05). For baby’s complications, white infants and infants from other races whose mothers resided in areas with a higher percentage of households below the poverty level had a higher risk of shoulder dystocia while infants of African American mothers who resided in census tracts with a higher percentage of earners below $35K were at higher risk for hospital revisit in <30 days (r=0.12, p<0.05). African American infants from neighborhoods with higher % of household below poverty level and no household vehicle had a higher likelihood of revisit.

Conclusion: Selected results show variations in complications among different races by neighborhood characteristics. The influence of race on GDM outcomes is linked to income and socioeconomic status. Income may be more important to GDM outcomes than race.


L. Thomas: None. M.R. Fawcett: None. C. Jurkovitz: None. J. Lenhard: Speaker’s Bureau; Self; Janssen Pharmaceuticals, Inc.


National Institutes of Health (U54GM104941)

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