DOI: 10.2337/db23-185-lb ISSN: 0012-1797

185-LB: Examining the Association between Neighborhood Socioeconomic Deprivation and Cesarean Section Rates among Women Diagnosed with Gestational Diabetes Mellitus—A Retrospective Analysis of the Maryland State Inpatient Database

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Introduction: The rising cesarean section (CS) rates in patients with Gestational Diabetes Mellitus (GDM) may be influenced by social determinants of health, including neighborhood socioeconomic deprivation. Recent research has highlighted the association between higher levels of neighborhood socioeconomic deprivation and increased rates of CS among women with GDM. Understanding this relationship is crucial for addressing health disparities and improving maternal and infant health outcomes in disadvantaged communities.

Objective: To determine the association between neighborhood socioeconomic deprivation (DCI) and incidences of cesarean section among women with GDM in Maryland.

Methodology: DCI and CS rates among women with GDM. We adjusted for potential confounding variables, including age, day of admission, insurance type, race/ethnicity, and income, in our final multivariate analysis.

Results: In our study period, we identified 17,326 cases of GDM, with a CS rate of 44.3%. We found a significant correlation between the level of socioeconomic deprivation in the neighborhood and the rate of CS among women with GDM. Women with GDM residing in the poorest communities had the highest odds of CS. Prosperous, reference, Comfortable, (OR=1.08, 95% CI 0.98-1.20, p=0.13), Mid-tier, (OR=1.14, 95% CI 1.02-1.26, p=0.02), At-Risk, (OR= 1.17, 95% CI 1.02-1.34, p=0.03), and Distressed, (OR=1.29, 95% CI 1.11-1.50, p=0.001).

Conclusion: Women with GDM residing in areas with the poorest communities have the highest incidence of CS, irrespective of other risk factors.


O. A. Akinyemi: None.

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