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.