SUN-529 Racial And Ethnic Disparities And Maternal-fetal Outcomes In Pregnant Women With Preexisting Diabetes Within A Large Healthcare System

Abstract Disclosure: F. Farrokhi: None. Y. Guo: None. R. Lane: None. T. Asuni: None. D. Kerr: None. Introduction: Pre-existing diabetes in pregnancy is associated with greater risk of maternal-fetal complications. However, few studies explore the impact of race and ethnicity on pregnancy outcomes using real-world data. The aim of this study is to compare real-world maternal-fetal outcomes among women with preexisting diabetes by race/ethnicity. Methods: ICD-10 codes were used to extract maternal and fetal outcome data for deliveries between 1/1/2021 and 8/31/2023 in women with preexisting type 1 (T1DM) and type 2 diabetes (T2DM) at Sutter Health, a large integrated healthcare system in Northern California. Data were stratified by race and ethnicity. Results: A total of 1717 deliveries included, 17% with T1DM and 83% with T2DM. Prevalence of race and ethnic groups were; 2.4% American Indian and Alaska Native/Native Hawaiian or Other Pacific Islander (AIAN/NHOPI), 20.4% Asian, 8.2% Black/African American, 43.2% Hispanic/Latino, 6.6% Other race/Multi-race, 18.3% White, 0.9% Unknown.T1DM was most common in White individuals (38%), and T2DM in Asian followed by Black/African American (91% and 89%) individuals (p<0.001). AIAN/NHOPI had the highest mean first trimester HbA1c (8.7%) and pre-pregnancy BMI (39), and the highest prevalence of preexisting hypertension (41%).Of known races, AIAN/NHOPI and Black/African Americans had higher rate of preterm delivery (27% and 25%, p=0.06) and admission to NICU (41% and 34%, p=0.006). White and Hispanic/Latino women had higher rates of macrosomia or large for gestation (16% and 15%, p=0.001. Small for gestational age was more common among Asian and women in Other or Multi-race categories (15% and 14%, p=0.002). Prevalence of preterm, pre-eclampsia, C-section, stillbirth, neonatal death, neonatal respiratory distress, shoulder dystocia, and neonatal hypoglycemia were not different across race and ethnic groups (p=NS). Conclusion: Among pregnant women with pre-existing diabetes, risk factors for adverse maternal-fetal outcomes and complications of pregnancy vary by race and ethnicity. Presentation: Sunday, July 13, 2025