By Kezia Ofosu Atta, Policy Assistant, Groundwork Ohio Follow Kezia on LinkedIn
The Intersection of Diabetes and Pregnancy
As November recognizes both Prematurity Awareness and American Diabetes Month, we must draw attention to the intersectionality of these conditions and their prevalence in the state of Ohio. Below you’ll find a summary of the data, recommendations on how to minimize and manage risks, links to local resources that support families, and updates on important legislation that can impact the prevalence of gestational diabetes in Ohio. Below you’ll find recommendations on how to minimize and manage risks, links to local resources that support families, and updates on important legislation that can impact the prevalence of gestational diabetes in Ohio.
According to the Centers for Disease Control and Prevention, about 1-to-2 percent of pregnant women in the United States develop type 1 or type 2 diabetes and about 6-9 percent of pregnant women develop gestational diabetes.
When considering the prevalence among racial and ethnic groups, they found that non-Hispanic, Asian mothers experience the highest rate of gestational diabetes at 14.9 cases, per 100 births. Although the study highlighted that “non-Hispanic Black women had the lowest rate of developing the disease at 6.5 per 100 births compared to all other groups,” they are more likely to develop type 2 diabetes following a gestational diabetes diagnosis.
Additionally, the 2022 National Vital Statistics report showed the gestational diabetes rate for non-Hispanic American Indian or Alaska Native Women to be the second highest, following Asian American women at 11.8 percent. The same report also indicated a high incidence of gestational diabetes in the Hispanic-American community at 8.5 percent.
We must draw attention to the increasing rate of this illness and its short- and long-term impacts on the lives of all mothers and babies, especially among older pregnant women, and women of color.
Developing gestational diabetes can place mom and baby’s health in jeopardy. It can lead to premature birth and poor birth outcomes, as babies born to mothers with gestational diabetes often grow too large, making birth difficult. Premature birth can also mean that a child is born before they develop critical independent tasks such as breathing and eating. Additionally, like the mother, the baby has a higher risk of developing low blood sugar or type 2 diabetes later in life.
The disparate prevalence of diabetes and its consequences during and after pregnancy requires us to strengthen and scale interventions to protect moms and babies.
According to the Profile of Prematurity in the United States released by March of Dimes, in 2021 there were 328,979 preterm births in the United States. This represented approximately 10.5 percent of live births that year. To break this down, among the 70,467 babies born in an average week in 2021, 7,384 were deemed preterm.
Over time, the United States has seen an increase in the number of preterm births, from 9.8 percent in 2011 to 10.5 percent in 2021. In a study by the National Institutes of Health, the incidence of overall preterm delivery in pregnant women with gestational diabetes was 17.5 percent, which is significantly higher than pregnant women without gestational diabetes whose rates were 8.5 percent. The rate of spontaneous preterm delivery for such women was also significantly higher at 15.8 percent compared to 7.1 percent for pregnant women who do not develop gestational diabetes.
The Impact on Ohio Moms and Babies
Pregnancy and birthing are both delicate processes that require dedicated attention to the health of both the mother and the child. Diabetes affects approximately 3 to 9 percent of all pregnancies in the state of Ohio. This equates to at least 9,000 pregnancies each year. In 2021, Ohio had a preterm birth rate of 10.6 percent, which was higher than the United States' rate of 10.5 percent. The recently released 2023 Report Card by March of Dimes shows that Ohio is still trending upwards with a preterm birth grade of D at 10.8 percent, while the United States rate dropped to 10.4 percent. They also added that diabetes caused birthing people to deliver preterm 30.9% of the time.
Therefore, mothers in Ohio have high rates of developing gestational diabetes that can increase the likelihood of preterm births.
What can be done to minimize the risk?
The Centers for Disease Control and Prevention recommends regular physical activity and achieving a healthy weight if a person is planning on conceiving. They urge pregnant women to check their blood sugar and eat healthy foods at the right times and in the right amounts. They also suggest pregnant women maintain moderate and consistent physical activity, as approved by a health care professional.
At the crux of these recommendations is the appeal to pregnant mothers and individuals planning on conceiving to attend medical appointments and seek a physician’s care to monitor their health and that of their babies to determine their potential risks and predeterminants. This is extremely important in Ohio as nearly 1 in 4 pregnant mothers in the state are not accessing prenatal care in their first trimester.
Additionally, support from the community is essential in assisting the mother in attending appointments, eating healthy, and staying relaxed and restful through pregnancy and childbirth. Individual, community, and collective efforts are vital to minimize our state’s prematurity and gestational diabetes rate.
How can you lend your voice NOW to support policies that support healthy moms and babies?
Recently, House Bill 190, a bill that designates the week of April 11 to 17th as Black Maternal Health Awareness Week, unanimously passed out of the House Public Health Policy Committee and is currently in the House Rules and Reference Committee awaiting to be placed on the House floor for votes. Additionally, House Bill 7, a bill that seeks to address maternal and infant mortality by supporting strong foundations for Ohio’s mothers and children by bolstering services, currently lies in the House Finance Committee awaiting passage. Within this bill, lies the support of initiatives that help expectant mothers access the care and support they need during pregnancies to prevent gestational diabetes and its associated risks. Bills like this help to raise awareness and strengthen wrap-around services to address the needs of Ohio’s mothers and children.
Please contact your Ohio State Representatives, urging them to pass these bills to decrease the prevalence and risks of gestational diabetes and preterm births in Ohio.
How can you connect to services?