Health >> JAMA Current Issue

Risk of Adverse Pregnancy Outcomes Among US Individuals With Gestational Diabetes by Race and Ethnicity

Link [2022-07-27 09:38:50]

To the Editor A recent study examined whether the frequency of adverse perinatal outcomes changed over time among individuals with gestational diabetes by racial and ethnic minority subgroups. However, we have concerns about this study’s reliance on administrative birth certificate data. Numerous validation studies have shown substantial underreporting of obstetric and neonatal conditions and procedures in birth certificate data. The National Center for Health Statistics, for example, reported gestational diabetes in birth certificate data from 2 states to have low sensitivity (58% to 59%) in comparison with medical records. Furthermore, this report found that a concerning proportion of birth certificate records that indicated gestational diabetes (44% in 1 state and 15% in the other state) did not have this diagnosis in the corresponding medical record. These data quality concerns extend to several outcomes examined in this study, such as maternal intensive care unit admission and transfusion, which were previously found in birth certificate data to have sensitivities of 20% and 12%, respectively.