Pregnancy outcomes in gestational diabetes mellitus: Ethnic-specific differences among a diverse Asian American population.

Introduction: The prevalence of gestational diabetes mellitus (GDM) is higher in Asian populations. Comparative data on pregnancy outcomes among specific ethnic groups within Asian cohorts are lacking. Our objective was to study Asian patients with GDM and describe perinatal outcomes by country of origin. Methods: Retrospective cohort study of Asian patients with GDM stratified by region of origin (East: China, Korea, Japan, Taiwan; Southeast: Philippines, Thailand, Vietnam; South: India) who delivered at a single institution from 2020 to 2023. Classification of race/ethnicity was self-reported. Comparisons by geographic subgroup were performed using chi-square tests. Multivariable logistic regression was then performed to adjust for potential confounders. Results: We identified 667 patients with GDM during the study period, of whom 274 (41%) identified as Asian (36% East, 32% Southeast, 32% South). Pre-pregnancy obesity was more likely among Southeast and South Asian patients compared to those from Eastern regions. South Asian patients were more likely to require insulin for blood glucose management and to develop suboptimal glycemic control, defined as failure to meet recommended glycemic targets > 50% of the time despite medical therapy. Southeast Asian patients were more likely to require rapid-acting insulin. These associations remained significant after adjustment for obesity. Other maternal and neonatal outcomes were similar between groups. Conclusion: There are differences in glycemic management needs between Asian ethnic groups. Though Asian race is a known risk factor for GDM, patients who identify as Asian represent a heterogeneous group with diverse backgrounds and different clinical outcomes.