Associations Between Rurality, pre-pregnancy Health Status, and Macrosomia in American Indian/Alaska Native...

Area of Science:

• Reproductive Health
• Perinatal Epidemiology
• Health Disparities

Background:

• Infant macrosomia poses significant risks to both mother and child.
• Understanding contributing factors among American Indian/Alaska Native (AI/AN) populations is crucial due to health disparities.

Purpose of the Study:

• To investigate the association of pre-pregnancy diabetes mellitus (DM), gestational diabetes mellitus (GDM), pre-pregnancy body mass index (BMI), and county-level social determinants of health with infant macrosomia.
• Focus on AI/AN women receiving Indian Health Service (IHS) care.

Main Methods:

• Analysis of 1,136 singleton births from AI/AN women within the IHS system (FY 2011).
• Utilized data from the IHS Improving Health Care Delivery Data Project.
• Employed multivariate generalized linear mixed models to assess associations.

Main Results:

• Overweight/obesity (66.2%) and GDM (12.8%) were prevalent.
• Pre-pregnancy DM (4.0%), overweight, obesity, and county-level rurality were significantly associated with increased odds of infant macrosomia.

Conclusions:

• Maternal overweight, obesity, pre-pregnancy DM, and rural social determinants are significant risk factors for infant macrosomia in this population.
• These factors represent potential targets for public health interventions aimed at reducing macrosomia rates among AI/AN women.