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American Journal of Epidemiology Vol. 147, No. 11: 1053-1061
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Influence of Diabetes during Pregnancy on Gastational Age-specific Newborn Weight among US Black and US White Infants

Edith C. Kieffer1, Greg R. Alexander2, Michael D. Kogan3, John H. Himes4, William H. Herman5, Joanne M. Mor6 and Robert Hayashi7

1Department of Health Behavior and Health Education, School of Public Health, University of Michigan Ann Arbor, Ml.
2Department of Maternal and Child Health, School of Public Health, University of Alabama at Birmingham Birmingham, AI.
3National Center for Health Statistics, Centers for Disease Control and Prevention Hyattsville, MD.
4Division of Epidemiology, School of Public Health, University of Minnesota Minneapolis, MN.
5Division of Endocrinology and Metabolism, School of Medicine, University of Michigan Ann Arbor, Ml.
6Maternal and Child Health Program, School of Public Health, University of Hawaii at Manoa Honolulu, HI.
7Division of Maternal-Fetal Medicine, School of Medicine, University of Michigan Ann Arbor, Ml.

This study examined the impact of maternal diabetes on birth weight for gestational age patterns of all term black infants and white infants in the United States using data derived from the 1990–1991 US Live Birth File of the National Center for Health Statistics. Infants of both black mothers and white mothers exhibited the expected fetal overgrowth associated with maternal diabetes. However, the increase in birth weight was much greater in infants of black than white diabetic mothers in comparison with their nondiabetic counterparts, as measured by the discrepancy in birth weight between infants of diabetic and nondiabetic mothers at each gestational week, the incidence of large for gestational age, high birth weight, small for gestational age, and low birth weight. After adjustment for maternal hypertension, prenatal care use, and sociodemographic factors, the disparity in mean birth weight associated with diabetes was 211.67 g in black infants and 115.74 g in white infants. The adjusted odds ratios of birth weight less double equals4,000 g were 2.98 (95% confidence interval 2.89–3.12) for black infants and 1.83 (95% confidence interval 1.78–1.89) for white infants. Given the potential risks for mothers and infants consequent to maternal diabetes and fetal hyperinsulinemia, further investigation of the prevalence, characteristics, and outcomes of diabetes during pregnancy among black mothers and infants is warranted. Am J Epidemiol 1998;147:1053–61.

birth weight; blacks; diabetes mellitus; fetal macrosomia; gestational age; pregnancy; prenatal care; whites


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