Association of cumulative social risk and gestational diabetes mellitus in the US, 2007–2018

Aims Little is known regarding the association of multiple social risk factors and gestational diabetes mellitus (GDM). Methods We analyzed the 2007–2018 National Health and Nutrition Examination Surveys including 10,439 women aged ≥20 years (8 % with history of GDM). We created a cumulative social risk score (CSR) by adding scores assigned to each of the following: race/ethnicity, citizenship status and country of birth, education, and family income (score of 0 used as reference group). Using logistic regression, we assessed the associations of individual social risk factors (education, income, race/ethnicity and citizenship status) and CSR score with GDM, adjusting for age, parity, insurance status, care access, smoking, diet, physical activity, and body mass index. Results Among individual social risk factors, being a non-U.S. citizen (OR:1.51, 95% CI: 1.06–2.15) or belonging to a minority racial/ethnic group (OR:1.30, 95% CI: 1.04–1.59) was significantly associated with a greater odds of GDM. When examining the combined effects of social risk factors, a CSR score ≥3 was associated with an increased odds of GDM (OR:1.64, 95% CI: 1.22–2.1). Conclusions Women with a greater burden of social risk factors are more likely to have GDM, thus should be the focus of interventions to prevent and treat GDM.