Maternal Education and Excessive Gestational Weight Gain in New York City, 1999–2001: The Effect of Race/Ethnicity and Neighborhood Socioeconomic Status

Abstract

To examine the association between maternal education and excessive gestational weight gain (EGWG) and whether this association differs by maternal race/ethnicity and neighborhood socio-economic status (SES). A sample of 56,911 New York City births between 1999 and 2001 was used. Self-reported EGWG was defined as gaining >40 pounds. Maternal education and race/ethnicity were obtained from birth record data. Neighborhood SES was determined from 2000 US Census data. Women with a high school [prevalence ratio (PR) = 1.21; 95 % CI 1.10–1.32] and some college (PR = 1.33; 95 % CI 1.21–1.47) education were more likely to gain excessive weight during pregnancy than their counterparts with less than a high school education. Having a college or more education was associated with a decreased EGWG for non-Hispanic white women (PR = 0.81; 95 % CI 0.67–0.96) but an increased EGWG for Hispanic women (PR = 1.25; 95 % CI 1.12–1.44). EGWG increased for women with a college or more education in medium and low SES neighborhoods (1.26; 95 % CI 1.04–1.53 and 1.20; 95 % CI 1.10–1.30, respectively); whereas a college or more education was not significant in the high SES neighborhoods. Our findings suggest that maternal education is associated with EGWG. However, this association depends on race/ethnicity and SES of the neighborhood of residence.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Institute of Medicine, Weight gain during pregnancy: Reexamining the guidelines, 2009: Washinton DC.

  2. 2.

    Martin, J. A., Peterson, H. B., Ventura, S. J., et al. (2010). Births: Final data for, in national vital statistics reports 2012. National Center for Health Statistics: Hyattsville, MD.

    Google Scholar 

  3. 3.

    Martin, J. A., Peterson, H. B., Sutton, P. D., Ventura, S. J., et al. (2005). Births: Final data for, in national vital statistics reports 2007. National Center for Health Statistics: Hyattsville, MD.

    Google Scholar 

  4. 4.

    Artal, R., Lockwood, C. J., & Brown, H. L. (2010). Weight gain recommendations in pregnancy and the obesity epidemic. Obstetrics and Gynecology, 115(1), 152–155.

    PubMed  Article  Google Scholar 

  5. 5.

    Johnson, J. W., Longmate, J. A., & Frentzen, B. (1992). Excessive maternal weight and pregnancy outcome. American Journal of Obstetrics and Gynecology, 167(2), 353–370. discussion 370–2.

    CAS  PubMed  Article  Google Scholar 

  6. 6.

    Jensen, D. M., et al. (2005). Gestational weight gain and pregnancy outcomes in 481 obese glucose-tolerant women. Diabetes Care, 28(9), 2118–2122.

    PubMed  Article  Google Scholar 

  7. 7.

    Cedergren, M. (2006). Effects of gestational weight gain and body mass index on obstetric outcome in Sweden. International Journal of Gynaecology and Obstetrics, 93(3), 269–274.

    CAS  PubMed  Article  Google Scholar 

  8. 8.

    Linne, Y., & Rossner, S. (2003). Interrelationships between weight development and weight retention in subsequent pregnancies: The SPAWN study. Acta Obstetricia et Gynecologica Scandinavica, 82(4), 318–325.

    PubMed  Article  Google Scholar 

  9. 9.

    Brennand, E. A., Dannenbaum, D., & Willows, N. D. (2005). Pregnancy outcomes of First Nations women in relation to pregravid weight and pregnancy weight gain. Journal of obstetrics and gynaecology Canada, 27(10), 936–944.

    PubMed  Article  Google Scholar 

  10. 10.

    Mamun, A. A., et al. (2010). Associations of excess weight gain during pregnancy with long-term maternal overweight and obesity: evidence from 21 y postpartum follow-up. American Journal of Clinical Nutrition, 91(5), 1336–1341.

    CAS  PubMed  Article  Google Scholar 

  11. 11.

    Amorim, A. R., et al. (2007). Does excess pregnancy weight gain constitute a major risk for increasing long-term BMI? Obesity (Silver Spring), 15(5), 1278–1286.

    Article  Google Scholar 

  12. 12.

    Linne, Y., et al. (2004). Long-term weight development in women: a 15-year follow-up of the effects of pregnancy. Obesity Research, 12(7), 1166–1178.

    PubMed  Article  Google Scholar 

  13. 13.

    Bellamy, L., et al. (2007). Pre-eclampsia and risk of cardiovascular disease and cancer in later life: Systematic review and meta-analysis. BMJ, 335(7627), 974.

    PubMed  PubMed Central  Article  Google Scholar 

  14. 14.

    James, S. A., et al. (2006). Life-course socioeconomic position and obesity in African American Women: The Pitt County Study. American Journal of Public Health, 96(3), 554–560.

    PubMed  PubMed Central  Article  Google Scholar 

  15. 15.

    Hazuda, H. P., et al. (1988). Effects of acculturation and socioeconomic status on obesity and diabetes in Mexican Americans. The San Antonio heart study. American Journal of Epidemiology, 128(6), 1289–1301.

    CAS  PubMed  Article  Google Scholar 

  16. 16.

    Kahn, H. S., & Williamson, D. F. (1991). Is race associated with weight change in US adults after adjustment for income, education, and marital factors? American Journal of Clinical Nutrition, 53(6 Suppl), 1566S–1570S.

    CAS  PubMed  Article  Google Scholar 

  17. 17.

    Kahn, H. S., & Williamson, D. F. (1990). The contributions of income, education and changing marital status to weight change among US men. International Journal of Obesity, 14(12), 1057–1068.

    CAS  PubMed  Google Scholar 

  18. 18.

    Kahn, H. S., Williamson, D. F., & Stevens, J. A. (1991). Race and weight change in US women: The roles of socioeconomic and marital status. American Journal of Public Health, 81(3), 319–323.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  19. 19.

    Zhang, Q., & Wang, Y. (2004). Trends in the association between obesity and socioeconomic status in US adults: 1971–2000. Obesity Research, 12(10), 1622–1632.

    PubMed  Article  Google Scholar 

  20. 20.

    Smith, G. D., et al. (1998). Individual social class, area-based deprivation, cardiovascular disease risk factors, and mortality: the Renfrew and Paisley Study. Journal of Epidemiology and Community Health, 52(6), 399–405.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  21. 21.

    Mobley, L. R., et al. (2004). Spatial analysis of body mass index and smoking behavior among WISEWOMAN participants. Journal of Women’s Health (Larchmt), 13(5), 519–528.

    Article  Google Scholar 

  22. 22.

    van Lenthe, F. J., & Mackenbach, J. P. (2002). Neighbourhood deprivation and overweight: The GLOBE study. International Journal of Obesity and Related Metabolic Disorders, 26(2), 234–240.

    PubMed  Article  Google Scholar 

  23. 23.

    Harrell, J. S., & Gore, S. V. (1998). Cardiovascular risk factors and socioeconomic status in African American and Caucasian women. Research in Nursing and Health, 21(4), 285–295.

    CAS  PubMed  Article  Google Scholar 

  24. 24.

    Robert, S. A., & Reither, E. N. (2004). A multilevel analysis of race, community disadvantage, and body mass index among adults in the US. Social Science and Medicine, 59(12), 2421–2434.

    PubMed  Article  Google Scholar 

  25. 25.

    Winkleby, M. A., Fortmann, S. P., & Barrett, D. C. (1990). Social class disparities in risk factors for disease: Eight-year prevalence patterns by level of education. Preventive Medicine, 19(1), 1–12.

    CAS  PubMed  Article  Google Scholar 

  26. 26.

    Galobardes, B., Morabia, A., & Bernstein, M. S. (2000). The differential effect of education and occupation on body mass and overweight in a sample of working people of the general population. Annals of Epidemiology, 10(8), 532–537.

    CAS  PubMed  Article  Google Scholar 

  27. 27.

    Mokdad, A. H., et al. (1999). The spread of the obesity epidemic in the United States, 1991–1998. JAMA, 282(16), 1519–1522.

    CAS  PubMed  Article  Google Scholar 

  28. 28.

    Monteiro, C. A., Conde, W. L., & Popkin, B. M. (2001). Independent effects of income and education on the risk of obesity in the Brazilian adult population. Journal of Nutrition, 131(3), 881S–886S.

    CAS  PubMed  Article  Google Scholar 

  29. 29.

    Chu, S.Y., et al., Gestational weight gain by body mass index among US women delivering live births, 2004–2005: Fueling future obesity. American journal of obstetrics and gynecology, 2009. 200(3): p. 271 e1–7.

    PubMed  Article  Google Scholar 

  30. 30.

    Lahti-Koski, M., et al. (2000). Age, education and occupation as determinants of trends in body mass index in Finland from 1982 to 1997. International Journal of Obesity and Related Metabolic Disorders, 24(12), 1669–1676.

    CAS  PubMed  Article  Google Scholar 

  31. 31.

    Centers for disease control, Morbidity and mortality weekly report, February 8, 2008. 57(05);127.

  32. 32.

    Flegal, K. M., et al. (1998). Overweight and obesity in the United States: Prevalence and trends, 1960–1994. International Journal of Obesity and Related Metabolic Disorders, 22(1), 39–47.

    CAS  PubMed  Article  Google Scholar 

  33. 33.

    Flegal, K. M., et al. (2010). Prevalence and trends in obesity among US adults, 1999–2008. JAMA, 303(3), 235–241.

    CAS  PubMed  Article  Google Scholar 

  34. 34.

    U.S. Census Bureau. (2011). Statistical abstract of the United States: 2012 (131st ed.). Washington, DC. http://www.census.gov/compendia/statab/.

  35. 35.

    Cummins, S. (2007). Commentary: Investigating neighbourhood effects on health–avoiding the ‘local trap’. International Journal of Epidemiology, 36(2), 355–357.

    PubMed  Article  Google Scholar 

  36. 36.

    Cummins, S. (2007). Neighbourhood food environment and diet: Time for improved conceptual models? Preventive Medicine, 44(3), 196–197.

    PubMed  Article  Google Scholar 

  37. 37.

    Cummins, S., & Macintyre, S. (2002). “Food deserts”—evidence and assumption in health policy making. BMJ, 325(7361), 436–438.

    PubMed  PubMed Central  Article  Google Scholar 

  38. 38.

    Zenk, S. N., et al. (2005). Neighborhood racial composition, neighborhood poverty, and the spatial accessibility of supermarkets in metropolitan Detroit. American Journal of Public Health, 95(4), 660–667.

    PubMed  PubMed Central  Article  Google Scholar 

  39. 39.

    Zenk, S. N., Schulz, A. J., & Odoms-Young, A. M. (2009). How neighborhood environments contribute to obesity. American Journal of Nursing, 109(7), 61–64.

    PubMed  Article  Google Scholar 

  40. 40.

    Lee, H. (2012). The role of local food availability in explaining obesity risk among young school-aged children. Social Science and Medicine, 74(8), 1193–1203.

    PubMed  Article  Google Scholar 

  41. 41.

    An, R., & Sturm, R. (2012). School and residential neighborhood food environment and diet among California youth. American Journal of Preventive Medicine, 42(2), 129–135.

    PubMed  PubMed Central  Article  Google Scholar 

  42. 42.

    Cubbin, C., Hadden, W. C., & Winkleby, M. A. (2001). Neighborhood context and cardiovascular disease risk factors: The contribution of material deprivation. Ethnicity and Disease, 11(4), 687–700.

    CAS  PubMed  Google Scholar 

  43. 43.

    Cahill M, L.J., Hamilton L. (2006) New York City DOE multiple pathways strategy, in NYC Department of Education.

  44. 44.

    Rehm, C. D., et al. (2008). Demographic and behavioral factors associated with daily sugar-sweetened soda consumption in New York City adults. Journal of Urban Health, 85(3), 375–385.

    PubMed  PubMed Central  Article  Google Scholar 

  45. 45.

    Sekhobo, J. P,.a.B., B, The relation of community occupational structure and prevalence of obesity in New York City Neighborhoods: An ecological analysis. Journal of Hunger and Environmental Nutrition, 2008. 3(1).

    Article  Google Scholar 

  46. 46.

    White, K., et al. (2011). Racial/ethnic residential segregation and self-reported hypertension among US- and foreign-born blacks in New York City. American Journal of Hypertension, 24(8), 904–910.

    PubMed  Article  Google Scholar 

  47. 47.

    NYC Department of health and mental hygiene. Community Health Survey. 2012 [cited 2012 May 10].

  48. 48.

    Borrell, L. N., et al. (2004). Neighbourhood characteristics and mortality in the Atherosclerosis Risk in Communities Study. International Journal of Epidemiology, 33(2), 398–407.

    PubMed  Article  Google Scholar 

  49. 49.

    Liang, K., et al. (1986). Longitudinal data analysis using generalized linear models. Biometrika, 73(1), 13–22.

    Article  Google Scholar 

  50. 50.

    Hu, F. B., et al. (1998). Comparison of population-averaged and subject-specific approaches for analyzing repeated binary outcomes. American Journal of Epidemiology, 147(7), 694–703.

    CAS  PubMed  Article  Google Scholar 

  51. 51.

    SAS Inc, SAS/STAT User’s Guide, Version 9.2, 2009: Cary, NC.

  52. 52.

    Burdette, H. L., & Whitaker, R. C. (2004). Neighborhood playgrounds, fast food restaurants, and crime: Relationships to overweight in low-income preschool children. Preventive Medicine, 38(1), 57–63.

    PubMed  Article  Google Scholar 

  53. 53.

    Timperio, A., et al. (2004). Perceptions about the local neighborhood and walking and cycling among children. Preventive Medicine, 38(1), 39–47.

    PubMed  Article  Google Scholar 

  54. 54.

    Wilson, D. K., et al. (2004). Socioeconomic status and perceptions of access and safety for physical activity. Annals of Behavioral Medicine, 28(1), 20–28.

    PubMed  Article  Google Scholar 

  55. 55.

    Winkleby, M. A., & Cubbin, C. (2003). Influence of individual and neighbourhood socioeconomic status on mortality among black, Mexican-American, and white women and men in the United States. Journal of Epidemiology and Community Health, 57(6), 444–452.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  56. 56.

    Diez-Roux, A. V., et al. (1997). Neighborhood environments and coronary heart disease: A multilevel analysis. American Journal of Epidemiology, 146(1), 48–63.

    CAS  PubMed  Article  Google Scholar 

  57. 57.

    Steptoe, A., & Feldman, P. J. (2001). Neighborhood problems as sources of chronic stress: Development of a measure of neighborhood problems, and associations with socioeconomic status and health. Annals of Behavioral Medicine, 23(3), 177–185.

    CAS  PubMed  Article  Google Scholar 

  58. 58.

    Sampson, R. J., Raudenbush, S. W., & Earls, F. (1997). Neighborhoods and violent crime: A multilevel study of collective efficacy. Science, 277(5328), 918–924.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  59. 59.

    Mostashari, F., et al. (2005). Smoking practices in New York City: The use of a population-based survey to guide policy-making and programming. J Urban Health, 82(1), 58–70.

    PubMed  PubMed Central  Article  Google Scholar 

  60. 60.

    Gunderson, E. P., Abrams, B., & Selvin, S. (2000). The relative importance of gestational gain and maternal characteristics associated with the risk of becoming overweight after pregnancy. International Journal of Obesity and Related Metabolic Disorders, 24(12), 1660–1668.

    CAS  PubMed  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Mary Huynh.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Huynh, M., Borrell, L.N. & Chambers, E.C. Maternal Education and Excessive Gestational Weight Gain in New York City, 1999–2001: The Effect of Race/Ethnicity and Neighborhood Socioeconomic Status. Matern Child Health J 18, 138–145 (2014). https://doi.org/10.1007/s10995-013-1246-5

Download citation

Keywords

  • Pregnancy
  • Weight gain
  • Education
  • Race/ethnicity
  • Neighborhood socioeconomic conditions