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Obesity (Silver Spring). 2016 Jul;24(7):1590-8. doi: 10.1002/oby.21532. Epub 2016 May 25.

The Impact of maternal obesity and race/ethnicity on perinatal outcomes: Independent and joint effects.

Author information

1
Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA.
2
School of Public Health, Oregon Health & Science University/Portland State University, Portland, Oregon, USA.
3
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
4
California Maternal Quality Care Collaborative (CMQCC), Stanford, California, USA.
5
Sutter Medical Center, Sacramento, Sacramento, California, USA.
6
University of California, Irvine Medical Center, Orange, California, USA.

Abstract

OBJECTIVE:

Independent and joint impacts of maternal race/ethnicity and obesity on adverse birth outcomes, including pre-eclampsia, low birth weight, and macrosomia, were characterized.

METHODS:

Retrospective cohort study of all 2007 California births was conducted using vital records and claims data. Maternal race/ethnicity and maternal body mass index (BMI) were the key exposures; their independent and joint impact on outcomes using regression models was analyzed.

RESULTS:

Racial/ethnic minority women of normal weight generally had higher risk as compared with white women of normal weight (e.g., African-American women, pre-eclampsia adjusted odds ratio [aOR] 1.60, 95% confidence interval [CI]: 1.48-1.74 vs. white women). However, elevated BMI did not usually confer additional risk (e.g., pre-eclampsia aOR comparing African-American women with excess weight with white women with excess weight, 1.17, 95% CI: 0.89-1.54). Obesity was a risk factor for low birth weight only among white women (excess weight aOR, 1.24, 95% CI: 1.04-1.49 vs. white women of normal weight) and not among racial/ethnic minority women (e.g., African-American women, 0.95, 95% CI: 0.83-1.08).

CONCLUSIONS:

These findings add nuance to our understanding of the interplay between maternal race/ethnicity, BMI, and perinatal outcomes. While the BMI/adverse outcome gradient appears weaker in racial/ethnic minority women, this reflects the overall risk increase in racial/ethnic minority women of all body sizes.

PMID:
27222008
PMCID:
PMC4925263
DOI:
10.1002/oby.21532
[Indexed for MEDLINE]
Free PMC Article

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