INTRODUCTION:The Centers for Disease Control and Prevention (CDC) birth certificate database recently published body mass index (BMI, calculated as weight (kg)/[height (m)] 2 ) information on U.S. pregnancies. The objective of this study was to study compliance with the Institute of Medicine (IOM) gestational weight gain recommendations by race and Hispanic origin.
METHODS:Singleton term (37 weeks of gestation or greater) births were identified from the 2011-2012 CDC birth certificate database from U.S. states with prepregnancy BMI and gestational weight gain data. These were compared for compliance with IOM guidelines for gestational weight gain for different ethnicities and races for each of the six prepregnancy BMI groups (BMI underweight, normal, overweight, obese I, II, III).
RESULTS:The study population consisted of 5,471,419 pregnancies. Of these, 48.8% were overweight, and 23.5% were obese. The highest obesity rate was in non-Hispanic blacks (32.7%) followed by Hispanics (25.7%), non-Hispanic whites (21.9%), and non-Hispanic others (11.3%). Approximately two thirds (67.7%) of all pregnant women were not in compliance with IOM recommendations for gestational weight gain. The lowest rate of compliance with IOM gestational weight gain recommendations was seen in non-Hispanic blacks (28.1%, odds ratio [OR] 0.77, 95% confidence interval [CI] 0.77-0.78), and then non-Hispanic whites (31.9%, OR 0.93, 95% CI 0.92-0.93), Hispanics (33.5%, OR 1), and non-Hispanic other races (38.4%, OR 1.24, 95% CI 1.23-1.24). Non-Hispanic whites were most likely to gain more weight than recommended (50.8%, OR 1.33, 95% CI 1.32-1.33), followed by non-Hispanic blacks (48.5%, OR 1.22, 95% CI 1.21-1.23), Hispanics (43.6%, OR 1), and non-Hispanic other races (36.4%, OR 0.74, 95% CI 0.73-0.75).CONCLUSION: Most pregnant women fail to meet IOM gestational weight gain recommendations. The highest noncompliance rates were among non-Hispanic blacks and non-Hispanic whites. The racial and ethnic disparities of prepregnancy BMI and compliance with gestational weight gain should be addressed to improve pregnancy outcomes.