Maternal Obesity and Diabetes as Risk Factors for Adverse Pregnancy Outcomes: Differences Among 4 Racial/Ethnic Groups

Abstract

In this large, population-based study, obesity and diabetes were independently associated with adverse pregnancy outcomes, highlighting the need for women to undergo lifestyle changes to help them control their weight during the childbearing years and beyond.

The Association Between Major Birth Defects and Preterm Birth

“…Very preterm infants (24-31 weeks) had an overall prevalence of birth defects 2.3 times that of moderately preterm infants (32-36 weeks). This gradient might have occurred because some factors such as maternal smoking and diabetes that increase the risk of very preterm birth are also related to the risk of certain birth defects [13,14]. The ascertainment of birth defects also depends on the thoroughness and training of the examiner [15].…”

“…Stratified analysis was used to assess factors potentially modifying the association between preterm birth and birth defects. Factors assessed included: maternal race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, other), maternal age in years (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), C35) number of previous live births (none, 1 or more), maternal education (\12 years, 12 years, [12 years), initiation of prenatal care (first trimester, second trimester, third trimester, no prenatal care), and delivery method (vaginal, vaginal birth after C-section, primary C-section, repeat C-section). To improve comparability, birth certificates were used as the source of these data for both the numerator and denominator.…”

Self-Reported Reproductive Outcomes Among Male and Female 1991 Gulf War era US Military Veterans

“…In multivariable modeling, age was not significantly associated with adverse reproductive outcomes for men or women; however, black, non-Hispanic women were significantly associated with increased odds for an adverse reproductive outcome in comparison with white, non-Hispanic women. This finding has been thoroughly documented in the US civilian population [51][52][53], and because we assume equal access to prenatal care among all active duty families, the observed modest association (adjusted OR, 1.45; 95% CI, 1.13-1.86), may reflect other pregnancy-related differences between black non-Hispanic women and white non-Hispanic women of approximately equal reproductive age, such as differences in obesity, hypertension, and diabetes [53][54][55][56][57]. A previous study utilized adult, married military members living in Hawaii and birth records to examine race/ethnicity differences in pregnancy outcomes [58].…”

Health Outcomes for Vaginal Compared With Cesarean Delivery of Appropriately Grown Preterm Neonates

“…Our study population was limited to deliveries in which birth certificates could be successfully linked to hospital discharge records utilizing a matching algorithm used in multiple other studies (n=1,025,903) (7,8,9). Our study population included women delivering cephalic-presenting, singleton neonates between 24 and 34 completed weeks of gestation (n=25,615).…”