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The Impact of maternal obesity and race/ethnicity on perinatal outcomes: Independent and joint effects
Author(s) -
Snowden Jonathan M.,
Mission John F.,
Marshall Nicole E.,
Quigley Brian,
Main Elliott,
Gilbert William M.,
Chung Judith H.,
Caughey Aaron B.
Publication year - 2016
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.21532
Subject(s) - medicine , body mass index , odds ratio , ethnic group , confidence interval , obesity , demography , eclampsia , obstetrics , birth weight , pregnancy , sociology , biology , anthropology , genetics
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.