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Examining rurality and social determinants of health among women with GDM: a 15-year comprehensive population analysis
Ali, Umama Cure, Laila Lewis, Rhonda K. Rattani, Ajita Hill, Twyla J. Woods, Nikki Keene
Ali, Umama
Cure, Laila
Lewis, Rhonda K.
Rattani, Ajita
Hill, Twyla J.
Woods, Nikki Keene
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Lewis_atAl.pdf
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Issue Date
2024-08-24
Type
Article
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Keywords
Gestational diabetes mellitus,Health disparities,Maternal obesity,Obese pre-pregnancy BMI,Pregnancy,Rural,Rural health,Rural-urban,Women's health
Subjects (LCSH)
Citation
Ali, U., Cure, L., Lewis, R.K. et al. Examining rurality and social determinants of health among women with GDM: a 15-year comprehensive population analysis. BMC Women's Health 24, 467 (2024). https://doi.org/10.1186/s12905-024-03306-6
Abstract
Background: Gestational diabetes mellitus (GDM) is a common pregnancy complication with long-term health consequences for mothers and their children. The escalating trends of GDM coupled with the growing prevalence of maternal obesity, a significant GDM risk factor projected to approach nearly 60% by 2030 in Kansas, has emerged as a pressing public health issue. Methods: The aim of this study was to compare GDM and maternal obesity trends in rural and urban areas and investigate maternal demographic characteristics influencing the risk of GDM development over a 15-year period. Trend analyses and a binary logistic regression were employed utilizing 2005 to 2019 de-identified birth record vital statistics from the Kansas Department of Health and Environment (N = 589,605). Results: Over the cumulative 15-year period, a higher prevalence of GDM was observed across age, race/ethnicity, education, and insurance source. Throughout this period, there was an increasing trend in both GDM and obese pre-pregnancy BMI age-adjusted prevalence, with noticeable rural-urban disparities. From 2005 to 2019, women, including Asians (OR: 2.73, 95% CI 2.58%-2.88%), American Indian or Alaskan Natives (OR: 1.58, 95%, CI 1.44-1.73%), Hispanics (OR: 1.42, 95% CI 1.37%-1.48%), women residing in rural areas (OR: 1.09, 95%, CI 1.06-1.12%), with advanced maternal age (35-39 years, OR: 4.83 95% CI 4.47%-5.22%; ?40 years, OR: 6.36 95%, CI 5.80-6.98%), with lower educational status (less than high school, OR: 1.15, 95% CI 1.10%-1.20%; high school graduate, OR: 1.10, 95% CI 1.06%-1.13%), Medicaid users (OR: 1.10, 95% CI 1.06%-1.13%), or with an overweight (OR: 1.78, 95% CI 1.72%-1.84%) or obese (OR: 3.61, 95% CI 3.50%-3.72%) pre-pregnancy BMI were found to be at an increased risk of developing GDM. Conclusions: There are persistent rural-urban and racial/ethnic disparities present from 2005 to 2019 among pregnant women in Kansas with or at-risk of GDM. There are several socioeconomic factors that contribute to these health disparities affecting GDM development. These findings, alongside with prominent rising maternal obesity trends, highlight the need to expand GDM services in a predominantly rural state, and implement culturally-responsive interventions for at-risk women. © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024.
Table of Contents
Description
Open Access
Publisher
Springer Nature
Journal
BMC Women's Health
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Series
Digital Collection
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Archival Collection
PubMed ID
ISSN
1472-6874