Category: Diabetes
Poster Session I
The social vulnerability index (SVI) measures a community’s vulnerability to external stressors on health and is composed of four themes (Table). Higher SVI scores (higher vulnerability) are associated with preterm birth, anemia, and delays in prenatal care. Our objective was to evaluate the association between SVI and gestational diabetes (GDM), and to evaluate which themes contribute to GDM.
Study Design:
Retrospective cohort study of all patients delivering > 20 weeks’ gestation at a single tertiary care center (2014–2018). Patients with pregestational diabetes or with only a PO box address were excluded. Patient addresses were used to assign a community-level overall SVI score and score for individual themes. SVI scores ranged between 0–1, with higher values demonstrating increased vulnerability. The primary outcome was GDM. Mean SVI scores with 95% CIs (overall SVI and theme scores) were compared between those with and without GDM. Individual theme components were also compared.
Results:
From 2014-2018, 14,675 patients were included for analysis: 1,199 (7.9%) had GDM. Compared to patients without GDM, patients with GDM had similar overall mean SVI scores (p=0.23, Table). Theme scores were also similar between groups, except those with GDM, paradoxically, had significantly less socioeconomic status (SES) vulnerability (lower Theme 1 mean SVI score). Moreover, patients with GDM were less likely to be below the poverty level and less likely to have no vehicle available. Patients with GDM were more likely to live with persons who speak English “less than well” (p < 0.05, Table).
Conclusion:
We did not demonstrate that patients with GDM have significantly higher social vulnerability compared to those without GDM. In fact, they may have less socioeconomic vulnerability. Surprisingly, patients with GDM may not be as socially disadvantaged as patients with other pregnancy specific diseases; other factors such as diet and physical activity may play a role, but further evaluation should be performed.
Kevin S. Shrestha, MD, MPH
Resident
University of Alabama at Birmingham
Birmingham, Alabama, United States
Christina T. Blanchard, MS
Statistician
Center for Women’s Reproductive Health, University of Alabama at Birmingham
Birmingham, Alabama, United States
Macie L. Champion, MD
Instructor/Fellow
University of Alabama at Birmingham
Birmingham, Alabama, United States
Ashley N. Battarbee, MD,MSCR
Assistant Professor
University of Alabama at Birmingham
Birmingham, Alabama, United States
Ariann Nassel, MA
University of Alabama at Birmingham
Birmingham, Alabama, United States
Akila Subramaniam, MD,MPH
Associate Professor
Center for Women’s Reproductive Health, University of Alabama at Birmingham
Birmingham, Alabama, United States