No abstract

The relations of exercise, employment, and other daily activities during pregnancy with pregnancy outcomes were examined using data from the Missouri Maternal and Infant Health Survey. Maternal surveys were available for the following singleton birth categories: 450 fetal deaths; 782 very low birth weight (VLBW, < 1,500 g); 802 moderately low birth weight (MLBW, 1,500-2,499 g); and 794 normal birth weight (NBW, > or = 2,500 g). All mothers were Missouri residents at the time of their December 1989 to March 1991 deliveries. It was found that VLBW mothers had exercised during pregnancy significantly less than NBW mothers. When compared with NBW mothers before pregnancy, VLBW mothers had been just as likely not to exercise as NBW mothers (odds ratio (OR) = 0.88, 95% confidence interval (CI) 0.69-1.12). During the first, second, and third trimesters, the odds ratios decreased to 0.70 (95% CI 0.53-0.92), 0.54 (95% CI 0.40-0.74), and 0.33 (95% CI 0.20-0.53), respectively. The VLBW mothers also were less likely to exercise during the third trimester than MLBW mothers (OR = 0.34, 95% CI 0.21-0.54) or mothers with fetal deaths (OR = 0.36, 95% CI 0.19-0.67). During the 3 months after pregnancy, none of the exercise odds ratios were statistically significant between groups. No significantly increased risks were found between employment during pregnancy or other daily activities and adverse pregnancy outcome. The study supports the recently relaxed guidelines of exercise during pregnancy.

No abstract

The tendency to repeat low birthweight (LBW < 2500 g) was studied in 182,285 linked first and second birth Missouri livebirths for 1978-90, of which 10,701 had first birth LBW. We examined the likelihood of LBW repetition by first birth birthweight, preterm delivery, and small-for-gestational-age (SGA) status by race, and the odd ratios (ORs) of repeat LBW for risk factors such as smoking, in comparison with ORs of second birth LBW among women with normal-weight first births. We found a strong tendency to repeat LBW (21%), especially following more extreme LBW first births. Adjusted ORs for repeat LBW were 10.1 for births that were preterm and SGA; 7.9 for preterm non-SGA; and 6.3 for SGA term births. Significant ORs of LBW repetition were found for smoking (1.52 and 1.85 for smoking in second pregnancy only and both pregnancies, respectively), short interpregnancy interval (1.33), and advanced maternal age (1.17), but the ORs were generally lower than those for women with normal-weight first births. Low pre-pregnancy weight was a significant risk factor for LBW repetition.

The higher proportion of black infants with very low birth weights is associated with a greater frequency of all major maternal conditions precipitating delivery among black women. Reductions in the disparity in birth weight between blacks and whites are not likely to result from any single clinical intervention but, rather, from comprehensive preventive strategies.