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Racial differences in contribution of prepregnancy obesity and excessive gestational weight gain to
Yanfang Guo1,2,3,4, Qun Miao5,6,7, Tianhua Huang5,8,9
1Better Outcomes Registry & Network Ontario, Ottawa, ON, Canada. yguo@bornontario.ca.
Insights
Excessive gestational weight gain and prepregnancy obesity contribute to large-for-gestational-age neonates, with racial differences observed. Excessive weight gain was a greater contributor in White and Asian populations, while contributions were similar in Black populations.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Health
- Public Health
Background:
- Maternal prepregnancy obesity and excessive gestational weight gain are recognized risk factors for adverse neonatal outcomes.
- Large-for-gestational-age (LGA) neonates are associated with increased risks of birth complications and long-term health issues.
- Racial disparities in maternal health and birth outcomes necessitate targeted investigations.
Purpose of the Study:
- To investigate the population attributable fraction (PAF) of prepregnancy obesity and excessive gestational weight gain on LGA neonates.
- To examine potential racial differences in the contribution of these risk factors to LGA neonates.
Main Methods:
- A population-based retrospective cohort study was conducted using data from the Ontario birth registry.
- Multivariable log-binomial regression models were employed to estimate the PAF and 95% confidence intervals (CI).
- Analyses were stratified by race, including White, Asian, and Black women.
Main Results:
- The prevalence of prepregnancy obesity, excessive gestational weight gain, and LGA neonates varied across racial groups.
- Excessive gestational weight gain contributed more to LGA neonates than prepregnancy obesity in White (32.9% vs. 16.6%) and Asian (32.1% vs. 11.8%) populations.
- In Black women, prepregnancy obesity (22.8%) and excessive gestational weight gain (20.1%) had similar contributions to LGA neonates.
Conclusions:
- Racial differences exist in the population attributable fraction of prepregnancy obesity and excessive gestational weight gain on LGA neonates.
- The varying prevalence of these risk factors across racial groups significantly influences their impact on LGA outcomes.
- Targeted public health interventions addressing maternal weight may be necessary to mitigate LGA risks in diverse populations.
Objectives:
To examine the racial differences in the population attributable fraction (PAF) of prepregnancy obesity and excessive gestational weight gain to large-for-gestational-age (LGA) neonates.
Methods:
We conducted a population-based retrospective cohort study among all women who had prenatal screening and had a singleton live birth in a hospital (1 April 2016-31 March 2017) using data from Ontario birth registry in Canada. We used multivariable log-binomial regression models to estimate the PAF and 95% confidence interval (CI) of LGA neonates due to prepregnancy obesity and excessive gestational weight gain. All models were stratified by race (White, Asian, and Black).
Results:
Of the 74,402 eligible women, the prevalence of prepregnancy obesity, excessive gestational weight gain, and LGA neonate was 21.1%, 60.0%, and 11.3%, respectively, for Whites; 9.3%, 45.9%, and 5.4%, respectively, for Asians; and 28.6%, 52.4%, and 7.9%, respectively, for Blacks. The association of prepregnancy obesity was greater than that of excessive gestational weight gain on LGA for all racial groups. Excessive gestational weight gain contributed more than prepregnancy obesity in Whites (PAF 32.9%, 95% CI [30.3-35.5%] and 16.6%, 95% CI [15.3-17.9%], respectively, for excessive gestational weight gain and prepregnancy obesity) and in Asians (PAF 32.1%, 95% CI [27.2-36.7%] and 11.8%, 95% CI [9.5-14.1%], respectively, for excessive gestational weight gain and prepregnancy obesity). Prepregnancy obesity (PAF 22.8%, 95% CI [17.1-28.1%]) and excessive gestational weight gain (PAF 20.1%, 95% CI [4.7-33.0%]) contributed to LGA neonates almost the same in Blacks.
Conclusions:
Excessive gestational weight gain contributed more to LGA neonates than prepregnancy obesity in Whites and Asians, while there was no difference between excessive gestational weight gain and prepregnancy obesity in their contributions to the LGA neonates in Blacks. The differences are mostly driven by the differential prevalence of the two risk factors across racial groups.
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