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

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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.

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Author information

Authors and Affiliations

  1. Department of Neonatal-Perinatal Medicine, St. Christopher’s Hospital for Children, Philadelphia, PA, USA

    B. E. de Jongh

  2. Department of Pediatrics, Drexel University College of Medicine, Philadelphia, PA, USA

    B. E. de Jongh

  3. Department of Neonatology, Christiana Care Health System, Newark, DE, USA

    D. A. Paul, M. Hoffman & R. Locke

  4. Department of Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA

    D. A. Paul & R. Locke

Authors
  1. B. E. de Jongh
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  2. D. A. Paul
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  3. M. Hoffman
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  4. R. Locke
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Correspondence to B. E. de Jongh.

Additional information

B. E. de Jongh, D. A. Paul, M. Hoffman and R. Locke contributed equally to this work.

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de Jongh, B.E., Paul, D.A., Hoffman, M. et al. Effects of Pre-pregnancy Obesity, Race/Ethnicity and Prematurity. Matern Child Health J 18, 511–517 (2014). https://doi.org/10.1007/s10995-013-1296-8

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  • DOI: https://doi.org/10.1007/s10995-013-1296-8

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