UCLA

Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications, affecting of 6-9% pregnancies in the United States (US). It is linked to adverse health outcomes for both mothers and their offspring. There are well-known racial/ethnic differences in GDM prevalence and GDM-related adverse outcomes, but the reasons for the differences remain unknown. For example, Asians have the highest prevalence of GDM, which cannot be explained by the well-established risk factors, such as overweight/obesity and low socioeconomic status. In addition, there is no global consensus on GDM diagnostic methods and cut-offs. Given maternal glucose levels are progressively linked to adverse outcomes, maternal hyperglycemia can be divided into more granular categories than just GDM vs. non-GDM.Regarding adverse health outcomes, it is still unclear whether GDM is associated with neurodevelopmental disorders (NDDs) in offspring and hypertension in mothers. This thesis utilized real-world data from electronic medical records and published cohort studies to answer research questions related to GDM in order to bridge existing research gaps. We found that the more granular maternal hyperglycemic categories also had racial/ethnic differences and distinct health implications. We also found that GDM was associated with NDDs among young offspring born to non-Hispanic White mothers with GDM. Furthermore, GDM was associated with hypertension later in life among mothers. These findings expand the current understanding of GDM diagnosis, GDM management, and GDM-related health implications.