2144-P: Residence in Low-Income, Low-Food-Access Neighborhoods Has Higher Prevalence of Gestational Diabetes Mellitus in California

Introduction and Objective: Living in neighborhoods with limited food access has been associated with adverse pregnancy outcomes with disease burden varying by race/ethnicity, whereas its role in gestational diabetes mellitus (GDM) remains unclear. We aimed to investigate the association of residing in low-income, low-food-access (LILA) neighborhoods during pregnancy with the prevalence of GDM in California and test effect modification by race/ethnicity. Methods: We included 1,758,943 singleton births among women who were aged 15-44 years, US residents, and without pre-pregnancy diabetes from the California Birth Certificate database (2018-2022). Census tract location of residence was linked to food access data from the US Food Access Research Atlas in 2019. LILA neighborhood was defined as 1) federal poverty rate ≥20% or median family income ≤80% of the statewide median family income, and 2) the nearest supermarket >0.5 mile for urban or >10 miles for rural areas. GDM was retrieved from the Certificate of Live Birth and Fetal Death Medical Data Supplement Worksheet as diabetes diagnosed in the index pregnancy. We used adjusted Poisson regression models with generalized estimating equations to estimate prevalence ratios (PR) and 95% confidence intervals (CI) for the cross-sectional associations, overall and stratified by race/ethnicity. Results: Residing in LILA neighborhoods was associated with a higher GDM prevalence (PR, 1.06; 95% CI, 1.03-1.08) in all participants. The interaction of LILA and race/ethnicity was statistically significant (P for interaction<0.001), with the strongest association among White (PR, 1.12; 95% CI, 1.07-1.16), followed by Hispanic (PR, 1.05; 95% CI, 1.02-1.08) and Asian (PR, 1.04; 95% CI, 1.01-1.18), and marginally significant among Black (PR, 1.05; 95% CI, 0.98-1.13). Conclusion: Residence in LILA neighborhoods during pregnancy was associated with a higher GDM prevalence, but the strength of the association slightly varied by race/ethnicity. Disclosure X. Ren: None. R. Chehab: None. C. Hsieh: None. Y. Zhu: None. L. Chen: None. Funding National Institute on Minority Health and Health Disparities (1R01MD018459)