Curr Diab Rep. 2025 May 14;25(1):33. doi: 10.1007/s11892-025-01587-1.
ABSTRACT
PURPOSE OF REVIEW: The rates of diabetes in pregnancy (type 1, type 2, and gestational diabetes) are increasing. Diabetes in pregnancy is associated with increased risk for maternal and neonatal complications. Certain groups are disproportionately affected by these complications and this paper reviews the data about disparities in diabetes in pregnancy and explores the social determinants of health (SDoH) underlying these disparities.
RECENT FINDINGS: Rates of diagnosis of gestational diabetes and pregestational diabetes are higher in racial and ethnic minority groups and people with socioeconomic disadvantage. There is higher all cause maternal mortality for Black people compared to White people. Emerging data suggests higher risk for adverse pregnancy outcomes for Black, American Indian, and Hispanic/Latina subjects with diabetes compared to White subjects. Individuals living in neighborhoods with higher poverty and less educational attainment also have higher rates of pregnancy and neonatal complications with diabetes. Diabetes in pregnancy is a complex condition which requires specialty care that can be time-consuming and costly. Individuals with disadvantages in income and employment, food security, social protection and support, and access to affordable and quality health services may be particularly susceptible to adverse outcomes of diabetes in pregnancy. Providers can reduce disparities by recognizing individuals with vulnerabilities in SDoH and tailoring treatment to social context. Equitable access to diabetes technology and postpartum care can also reduce disparities in outcomes.
PMID:40366501 | PMC:PMC12078402 | DOI:10.1007/s11892-025-01587-1
Matern Child Health J. 2025 May;29(5):696-702. doi: 10.1007/s10995-025-04094-7. Epub 2025 May 1.
ABSTRACT
OBJECTIVES: The prevalence of intrauterine fetal demise (IUFD) in the United States is 5.74 per 1000 live births. In Maryland, the prevalence is 6.75 per 1000 and occurs nearly twice as frequently in Black than in white populations. At MedStar Franklin Square Medical Center (MFSMC), Electronic Medical Records (EMR) show that IUFDs are 2.5 times greater in Black than white women. This analysis aims to identify factors that contribute to this health disparity.
METHODS: We performed a retrospective chart review of deliveries at MFSMC between 2018 and 2020. Literature-supported variables were collected for all pregnancies that ended in IUFD. Using logistic regression models, these factors were analyzed to isolate predictors for IUFD and association with race. The same predictors were compared to those of women who delivered live infants during this period.
RESULTS: Without adjustment, the odds of having an IUFD are 2.21 times higher for Black mothers than for white mothers at MFSMC. No other unadjusted odds ratios between comorbid risk factors and the chance of IUFD were significant. After adjusting for diabetes, growth restriction, substance abuse, and hypertension, the odds of having an IUFD are 2.31 times higher for Black than white mothers.
CONCLUSIONS: Black mothers experience increased risk for IUFD, after controlling for other pertinent factors. This disparity should be addressed by reducing healthcare provider bias, increasing maternal health services, and providing comprehensive patient education.
PMID:40310602 | DOI:10.1007/s10995-025-04094-7
Front Public Health. 2025 Apr 15;13:1544903. doi: 10.3389/fpubh.2025.1544903. eCollection 2025.
ABSTRACT
INTRODUCTION: Birmingham and Solihull face significant challenges related to adverse birth outcomes. This study aimed to identify demographic, socioeconomic, and lifestyle factors associated with an increased risk of low birth weight, premature birth, stillbirth, and neonatal death in Birmingham and Solihull.
METHODS: Births (n = 41, 231) between October 2020 and April 2023 were analysed. The attributable fraction of premature births and low birth weight (LBW) attributable to socioeconomic and ethnic inequality was calculated. Multiple logistic regression analyses identified groups that had increased odds of premature birth (n = 3, 312), LBW (n = 1, 197), stillbirth (n = 173), and neonatal death (n = 208).
RESULTS: Attributable fraction analysis estimated that 191 premature births and 211 LBWs each year would not have occurred if all women had the same rates as White women living in the least deprived areas. Ethnicity, socioeconomic deprivation, medical care, lifestyle, and vulnerability status were found to be significant risk factors for adverse birth outcomes. Asian and Black women had 1.4-2.7 times the odds of LBW compared to White women (p < 0.01). Black women had increased odds of stillbirth (OR : 1.75, p = 0.017) and Asian women had increased odds of neonatal death (OR : 1.90, p < 0.001). The odds of LBW (OR : 3.3), premature birth (OR : 27.2), and neonatal death (OR : 5.6) were significantly increased for twins (p < 0.001). For women smoking at delivery, the odds of LBW (OR : 2.3), premature birth (OR : 1.5), and stillbirth (OR : 1.6) were significantly increased (p < 0.05). Deprivation, and/or financial and housing issues also increased the odds of adverse birth outcomes (p < 0.05).
DISCUSSION: These findings underscore the importance of targeted interventions and support for at-risk populations to reduce adverse birth outcomes in vulnerable communities.
PMID:40302778 | PMC:PMC12037573 | DOI:10.3389/fpubh.2025.1544903
Matern Child Health J. 2025 May;29(5):676-685. doi: 10.1007/s10995-025-04092-9. Epub 2025 Apr 29.
ABSTRACT
OBJECTIVE: This study examines the critical issue of maternal health among tribal women in developing countries, with a specific focus on the Bakerwal tribe in Kashmir. Tribal women encounter significant challenges, including poverty, restricted access to medical facilities, and inadequate maternal care. Understanding these barriers is essential for addressing maternal health disparities and improving healthcare interventions tailored to their unique socio-cultural and economic conditions.
METHODOLOGY: The research was conducted among the Bakerwal community in Check Village, Anantnag, using a qualitative approach to explore maternal health experiences. Given the community's low literacy levels, restricted healthcare access, and limited social mobility, data were collected from 20 tribal women who had recently given birth. Employing purposive sampling and guided by the principle of data saturation, in-depth interviews were conducted with 12 Bakerwal women and 5 healthcare professionals specializing in maternal care. This approach facilitated a deeper understanding of the maternal health challenges within the cultural and socio-economic context of the community.
RESULTS: The study reveals that Bakerwal tribal women are experiencing a transitional phase in maternal health, shaped by socio-economic and cultural challenges. Poverty restricts their ability to afford nutritious food, exacerbating malnutrition and related health risks. Limited awareness and deeply rooted cultural norms further hinder the integration of pregnancy into their daily lives. Financial constraints not only reinforce stereotypes but also contribute to infrequent hospital visits, limiting access to essential maternal healthcare. Despite their heightened vulnerability to health risks, significant barriers, including geographical isolation, inadequate healthcare infrastructure, and cultural apprehensions, continue to obstruct their access to timely medical treatment.
CONCLUSION: The maternal health of Bakerwal tribal women in Kashmir faces significant challenges at the intersection of poverty, cultural norms, and limited healthcare access. Economic constraints, lack of awareness, and the marginalization of pregnancy within their lifestyle contribute to malnutrition, infrequent hospital visits, and heightened health risks. Caught between tradition and modernity, their maternal health remains vulnerable to systemic disparities. Addressing these issues requires culturally sensitive interventions, improved healthcare infrastructure, and targeted awareness programs to bridge existing gaps and ensure equitable maternal care.
PMID:40299167 | DOI:10.1007/s10995-025-04092-9
Int J Equity Health. 2025 Apr 28;24(1):114. doi: 10.1186/s12939-025-02488-1.
ABSTRACT
Black maternal mortality in the United States remains alarmingly high-Black women are still more than three times as likely to die from pregnancy-related causes than White women. This crisis is not due to individual choices or access alone, but to deeply rooted structural inequities, including systemic racism, policy exclusion, and the neglect of Black-led care models. While efforts like Medicaid expansion and the Black Maternal Health Momnibus Act aim to address these gaps, they often fall short by relying on narrow, one-size-fits-all solutions. This commentary uses Critical Health Equity theory and the Intersectionality-Based Policy Analysis (IBPA) framework to examine how current policies may unintentionally reinforce the very inequities they seek to eliminate. It argues that achieving real equity in maternal health requires more than reform-it calls for a fundamental shift in who holds power, whose knowledge is valued, and how care is delivered. A new framework is proposed that centers Black leadership, supports community-led research, and promotes culturally safe, justice-oriented care.
PMID:40296089 | PMC:PMC12039294 | DOI:10.1186/s12939-025-02488-1