Evidence map›Paper›PMID 39937554›Full record

ArticleDiabetes care2025

Association of Historical Redlining With Gestational Diabetes Mellitus: The Mediating Role of BMI and Area Deprivation Index.

Wajeeha Umer, Yi Sun, Anqi Jiao, Karen D Lincoln, Mengyi Li, Chantal C Avila, Vicki Y Chiu, Jeff M Slezak, David A Sacks, John Molitor and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Wajeeha UmerDepartment of Environmental and Occupational Health, Joe C. Wen School of Population & Public Health, University of California, Irvine, CA.ORCID 0000-0002-9765-817X
Yi SunDepartment of Environmental and Occupational Health, Joe C. Wen School of Population & Public Health, University of California, Irvine, CA.
Anqi JiaoDepartment of Environmental and Occupational Health, Joe C. Wen School of Population & Public Health, University of California, Irvine, CA.
Karen D LincolnDepartment of Environmental and Occupational Health, Joe C. Wen School of Population & Public Health, University of California, Irvine, CA.
Mengyi LiDepartment of Environmental and Occupational Health, Joe C. Wen School of Population & Public Health, University of California, Irvine, CA.
Chantal C AvilaDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
Vicki Y ChiuDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
Jeff M SlezakDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
David A SacksDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
John MolitorCollege of Public Health and Human Sciences, Oregon State University, Corvallis, OR.
Tarik BenmarhniaScripps Institution of Oceanography, University of California, San Diego, CA.
Jiu-Chiuan ChenPopulation & Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Darios GetahunDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
Jun WuDepartment of Environmental and Occupational Health, Joe C. Wen School of Population & Public Health, University of California, Irvine, CA.

Funding

Environmental and Social Health Determinants of Pregnancy Outcomes Related to COVID-19 PandemicR01ES030353 · NIEHS · UNIVERSITY OF CALIFORNIA-IRVINE · PI GETAHUN, DARIOS, WU, JUN · 2019 to 2022
$3.2M
NIEHS NIH HHS R01 ES030353NIEHS NIH HHS R01ES030353
6 · The paper itself

Abstract

objectiveWe investigated the association between historic redlining and risk of gestational diabetes mellitus (GDM) and whether this relationship is mediated by maternal obesity and area-level deprivation. RESEARCH DESIGN AND

methodsThis retrospective study included 86,834 singleton pregnancies from Kaiser Permanente Southern California's health records (2008-2018). Redlining was assessed using digitized Home Owners' Loan Corporation (HOLC) maps, with patients' residential addresses geocoded and assigned HOLC grades (A, B, C, or D) based on their geographic location within HOLC-graded zones. For GDM case patients, exposure was assigned based on address at diagnosis date; for noncase patients, it was assigned based on address during the 24th to 28th gestational week. Health records were combined with area deprivation index (ADI) from 2011 to 2015 census data. Mixed-effect logistic regression models assessed associations between redlining and GDM, with mediation by BMI and ADI evaluated using inverse odds ratio weighting. Models were adjusted for maternal age, education, race and ethnicity, neighborhood-level income, and smoking status.

resultsAmong the 10,134 (11.67%) GDM case patients, we found increased risk of GDM in B ("still desirable," adjusted odds ratio [aOR] 1.20, 95% CI 0.99-1.44), C-graded ("definitely declining," aOR 1.22, 95% CI 1.02-1.47), and D-graded ("hazardous," i.e., redlined, aOR 1.30, 95% CI 1.08-1.57) neighborhoods compared with the "best"-graded zone. Prepregnancy BMI and ADI mediated 44.2% and 64.5% of the increased GDM risk among mothers in redlined areas.

conclusionsHistoric redlining is associated with an increased risk of GDM, mediated by maternal obesity and neighborhood deprivation. Future research is needed to explore the complex pathways linking redlining to pregnancy outcomes.

Indexed as

Body Mass IndexDiabetes, GestationalAdultCaliforniaFemaleHumansPregnancyRetrospective StudiesRisk FactorsYoung Adult

Identifiers

PMID39937554
PMCPMC12034896

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.