Physicians have counseled patients to make patient-level lifestyle approaches to prevent and mitigate chronic medical conditions such as diabetes and hypertension. With GDM and hypertensive disorders of pregnancy both being associated with preterm birth and increased fetal and maternal morbidity, these conditions place a large burden on our public health system’s ability to deliver cost effective health care. Risk factors for GDM and preeclampsia include advanced maternal age, multiple gestation, African-American race, Hispanic ethnicity, obesity, excessive maternal weight gain as well as lower socioeconomic status. Prenatal care is structured around detecting this serious condition which is associated with maternal death, intrauterine fetal demise, preterm birth and placental abruption. Preeclampsia, defined as new onset hypertension and proteinuria during pregnancy, complicates approximately 3 % of all pregnancies. Hypertensive disorders complicate nearly 12–22 % of all pregnancies and is the second leading cause of maternal death in the United States. Gestational diabetes is associated with increased maternal and fetal morbidity and mortality including preterm birth, birth injury, cesarean delivery, intrauterine fetal demise, placental abruption, polyhydramnios and pre-eclampsia. Gestational diabetes (GDM) occurs in approximately 5–6 % of pregnancies. Conclusion The distribution of community resources has a significant association with the risk of developing GDM but not preeclampsia. There were no significant relationships between preeclampsia and the concentration of fast food restaurants, grocery store, supermarkets or the amount of green space.
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The adjusted risk of GDM was reduced in zip codes with greater concentration of grocery stores and supermarkets (RR 0.94, 95 % CI 0.90–0.98). Results There were 9692 cases of GDM and 6288 cases of preeclampsia corresponding to incidences of 2.5 and 1.4 % respectively. Unadjusted and adjusted risk ratios were calculated using negative binomial regression.
California Birth Certificate data was used to identify cases of GDM and preeclampsia. Fast food restaurants, supermarkets, grocery stores, gyms, health clubs and green space were identified using Google © Maps Extractor and through the Southern California Association of Government. Methods An ecological study was performed in Los Angeles and Orange counties in California. Objective To determine the risk of gestational diabetes (GDM) and preeclampsia associated with various community resources.
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