Association Between Inadequate Gestational Weight Gain and Infant Mortality Among U.S. Infants Born in 2002

BACKGROUND: More than 28,000 babies died before their first birthday in the United States in 2002. Low birth weight (less than 2500g) is the second leading causes of U.S. infant deaths. Researchers have consistently demonstrated a strong relationship between maternal weight gain and infant low birth weight. The purpose of this study was to determine the relative importance of inadequate gestational weight gain as a cause of infant mortality. METHODS: The study population was drawn from a random sample of 100,000 records from the National Center for Health Statistics' 2002 Linked Birth/ Infant Death Data Set. Descriptive and proportional hazards regression analyses were used to assess the risk of infant mortality associated with inadequate gestational weight gain compared to normal weight gain. RESULTS: Inadequate gestational weight gain was associated with increased odds of infant death. The increased risk remained after adjustment for gestational age (AOR [adjusted odds ratio] =2.263, p<0.0001, 95% CI [confidence interval]: 1.87, 2.74), maternal age (AOR=2.23, p<0.0001, 95% CI: 1.84, 2.70), low birth weight (AOR=1.92, p<0.0001, 95% CI: 1.59, 2.33), maternal race (1.89, p<0.0001, 95% CI: 1.56, 2.23), and maternal education (AOR=1.84, p<0.0001, 95% CI: 1.59, 2.34). Among racial and ethnic subgroups, African American women with inadequate maternal weight gain were 1.3 times (p<0.01, 95% CI: 1.08, 1.63) more likely than white women to have infant death. CONCLUSION: There is a substantial and significant association between inadequate gestational weight gain and infant death.