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Gestational Diabetes and Breastfeeding Among Women of Different Races/Ethnicities: Evidence from the Pregnancy Risk Assessment Monitoring Surveys

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Objective

To examine risk factors for gestational diabetes mellitus (GDM) and factors associated with breastfeeding patterns among women with GDM from different racial/ethnic groups.

Methods

We used data from Phase 8 (2016–2018) of the Pregnancy Risk Assessment Monitoring System. We used logistic regression to estimate factors associated with GDM and with breastfeeding initiation, and conducted survival analysis using Kaplan–Meier curves, and Cox proportional hazards regression to analyze early cessation of breastfeeding.

Results

Among American Indian and Alaska Native (AI/AN) women, higher education reduced odds (aOR = 0.33; 95% CI: 0.19–0.59) and being married increased odds (aOR = 1.35; 95% CI: 1.02–1.79) of GDM. AI/AN women who received WIC benefits had lower odds of initiating breastfeeding (aOR = 0.70; 95% CI: 0.51–0.95). While there was no association between GDM and initiation of breastfeeding, only a third of AI/AN women with GDM were still breastfeeding by 36 weeks postpartum, compared to more than half of non-Hispanic White and Hispanic women.

Conclusions for Practice

Efforts to reduce GDM among those most at risk are needed, especially among racial and ethnic minorities. Increasing support for women with GDM to continue to breastfeed may improve maternal and child health outcomes and reduce health disparities, particularly among AI/AN women.

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Data Availability

Data is available upon application to the PRAMS Working Group.

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Acknowledgements

The authors wish to thank the Centers for Disease Control and Prevention and the PRAMS Working Group for the PRAMS data.

Funding

This research was supported by the Center for American Indian and Alaska Native Diabetes Translation Research, through a grant (P30DK092923) awarded by the National Institute of Diabetes and Digestive and Kidney Diseases.

Author information

Authors and Affiliations

  1. Institute for Research and Education to Advance Community Health (IREACH), 1100 Olive Way, Suite 1200, Seattle, WA, 98101, USA

    Luciana E. Hebert, Cassandra J. Nikolaus, Anna Zamora-Kapoor & Ka’imi A. Sinclair

  2. Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA

    Luciana E. Hebert, Cassandra J. Nikolaus & Anna Zamora-Kapoor

  3. Department of Sociology, Washington State University, Pullman, WA, USA

    Anna Zamora-Kapoor

  4. College of Nursing, Washington State University, Spokane, WA, USA

    Ka’imi A. Sinclair

Authors
  1. Luciana E. Hebert
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  4. Ka’imi A. Sinclair
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Contributions

LEH conceived of and secured funding for the project, conducted all data analysis, and drafted the paper. CJ, AZK, and KS provided critical feedback on the analysis and manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Luciana E. Hebert.

Ethics declarations

Ethics Approval

Our study was exempt from ethical review because it did not meet the federal definition of human subjects research (45 CFR 46.102).

Consent to Participate

This is a secondary data analysis; therefore, no consent was obtained directly from participants for this analysis; however, the original PRAMS surveys from which the data is drawn did obtain informed consent from all participants.

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All authors give their consent to publish this manuscript.

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The authors declare no competing interests.

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Hebert, L.E., Nikolaus, C.J., Zamora-Kapoor, A. et al. Gestational Diabetes and Breastfeeding Among Women of Different Races/Ethnicities: Evidence from the Pregnancy Risk Assessment Monitoring Surveys. J. Racial and Ethnic Health Disparities 10, 1721–1734 (2023). https://doi.org/10.1007/s40615-022-01356-w

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