Maternal and Child Health Journal

, Volume 18, Issue 3, pp 511–517

Effects of Pre-pregnancy Obesity, Race/Ethnicity and Prematurity

  • B. E. de Jongh
  • D. A. Paul
  • M. Hoffman
  • R. Locke
Brief Report

DOI: 10.1007/s10995-013-1296-8

Cite this article as:
de Jongh, B.E., Paul, D.A., Hoffman, M. et al. Matern Child Health J (2014) 18: 511. doi:10.1007/s10995-013-1296-8

Abstract

To investigate the association between maternal pre-pregnancy obesity, race/ethnicity and prematurity. Retrospective cohort study of maternal deliveries at a single regional center from 2009 to 2010 time period (n = 11,711). Generalized linear models were used for the analysis to estimate an adjusted odds ratio with 95 % confidence interval of the association between maternal pre-pregnancy obesity, race/ethnicity and prematurity. Analysis controlled for diabetes, chronic hypertension, previous preterm birth, smoking and insurance status. The demographics of the study population were as follows, race/ethnicity had predominance in the White/Non-Hispanic population with 60.1 %, followed by the Black/Non-Hispanic population 24.2 %, the Hispanic population with 10.3 % and the Asian population with 5.4 %. Maternal pre-pregnancy weight showed that the population with a normal body mass index (BMI) was 49.4 %, followed by the population being overweight with 26.2 %, and last, the population which was obese with 24.4 %. Maternal obesity increased the odds of prematurity in the White/Non-Hispanic, Hispanic and Asian population (aOR 1.40, CI 1.12–1.75; aOR 2.20, CI 1.23–3.95; aOR 3.07, CI 1.16–8.13, respectively). Although the Black/Non-Hispanic population prematurity rate remains higher than the other race/ethnicity populations, the Black/Non-Hispanic population did not have an increased odds of prematurity in obese mothers (OR 0.87; CI 0.68–1.19). Unlike White/Non-Hispanic, Asian and Hispanic mothers, normal pre-pregnancy BMI in Black/Non-Hispanic mothers was not associated with lower odds for prematurity. The odds for mothers of the White/Non-Hispanic, Hispanic and Asian populations, for delivering a premature infant, were significantly increased when obese. Analysis controlled for chronic hypertension, diabetes, insurance status, prior preterm birth and smoking. Obesity is a risk factor for prematurity in the White/Non-Hispanic, Asian and Hispanic population, but not for the Black/Non-Hispanic population. The design and evaluation of weight-based maternal health programs that aggregate race/ethnicity may not be sufficient. The optimal method to address maternal pre-pregnancy and intra-pregnancy weight-related health disorders may need to be stratified along race/ethnicity adjusted strategies and goals. However, a more global preventative strategy that encompasses the social determinants of health may be needed to reduce the higher rates of prematurity among the Black/Non-Hispanic population.

Keywords

Body mass index Prematurity Obesity Racial disparities 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • B. E. de Jongh
    • 1
    • 2
  • D. A. Paul
    • 3
    • 4
  • M. Hoffman
    • 3
  • R. Locke
    • 3
    • 4
  1. 1.Department of Neonatal-Perinatal MedicineSt. Christopher’s Hospital for ChildrenPhiladelphiaUSA
  2. 2.Department of PediatricsDrexel University College of MedicinePhiladelphiaUSA
  3. 3.Department of NeonatologyChristiana Care Health SystemNewarkUSA
  4. 4.Department of PediatricsThomas Jefferson UniversityPhiladelphiaUSA

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