OBJECTIVE: To evaluate the usefulness of linking birth certificate and census data to explore socioeconomic disparities in diabetic pregnancy. METHODS: Birth certificate data, representing 186,480 births to Minnesota residents in the Minneapolis/St. Paul metropolitan area during 1993-1997, were linked by maternal residence addresses to census tracts from the 1990 U.S. Census. Over 98% were successfully matched. Tracts were stratified based on: Percent of residents living below poverty; percent of residents 25 years or older who had not completed high school; and percent of residents in working class occupations. Prevalence and outcomes of diabetic pregnancies were mapped by tract to look for geographic patterns. RESULTS: Racial and ethnic disparities persisted within socioeconomic strata in the prevalence of births complicated by pre-existing diabetes mellitus (PEDM) and gestational diabetes mellitus (GDM). Among mothers with PEDM, congenital anomalies were 1.8 times more common in lower census strata than in higher strata. Mothers with diabetes (PEDM or GDM) in the lowest census strata were two to three times more likely than those in the highest strata to have received inadequate prenatal care. Logistic regression models will be used to explore the contribution of additional risk factors. CONCLUSIONS: Socioeconomic factors may affect the prevalence and outcomes of diabetic pregnancy. This exploratory analysis will elucidate the contribution of socioeconomic environment to individual maternal and infant health, and may help design more effective programs to address diabetic pregnancy.
Learning Objectives: At the conclusion of this presentation, the participant will be able to: (1) List three ways that linking census data with birth certificates may enhance understanding of birth outcomes in diabetic pregnancies. (2) List three limitations of using census data as a proxy for maternal socioeconomic status. (3) Assess the use of mapping for diabetic pregnancies
Keywords: Diabetes, Pregnancy
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.