Ethnicity and Immigration Status as Risk Factors for Gestational Diabetes Mellitus, Anemia and Pregnancy Outcomes Among Food Insecure Women Attending the Montreal Diet Dispensary Program.

Abstract

The primary aim of this study was to characterize the rate of adverse pregnancy outcomes in a multicultural group of low-income women.Data were extracted from the Montreal Diet Dispensary's database between June 2013 and December 2015. Risk was evaluated using logistic regression adjusted for covariates.Of the 1,387 pregnancies, the prevalence of gestational diabetes mellitus (GDM) was 17.2% (95% confidence interval [CI], 15.1% to 19.3%), maternal anemia 44.9% (95% CI, 41.9% to 47.9%) and hypertension 3.8% (95% CI, 2.8% to 4.8%). The prevalence of small-for-gestational-age infants was 5.5% (95% CI, 4.3% to 6.7%), preterm births 4.7% (95% CI, 3.6% to 5.9%), low birthweight 4.2% (95% CI, 3.1% to 5.2%) and large-for-gestational-age infants was 10.6% (95% CI, 9.0% to 12.2%). Asian women had an increased odds of gestational diabetes mellitus (adjusted odds ratio [aOR], 1.86; 95% CI, 1.17 to 2.98) and SGA infants (aOR, 2.35; 95% CI 1.21 to 4.57) compared with white women. Anemia was more likely for black women compared with white women (aOR, 1.74; 95% CI, 1.29 to 2.35). Black women were more at risk of preterm birth (aOR, 1.79; 95% CI, 1.01 to 3.19). Immigrants showed an increased risk of maternal anemia compared with Canadian-born women (aOR, 1.85; 95% CI, 1.06 to 3.21).As disparities in maternal and infant outcomes were present, nutritional intervention(s) need to be targeted toward prevention of adverse pregnancy outcomes, prioritization of higher-risk groups and adaptation of the program to a multiethnic low-income population.