256150 Combined Effects of Pre-pregnancy Body Mass Index and Weight Gain During Pregnancy on the Risk of Infant Death

Wednesday, October 31, 2012 : 10:52 AM - 11:09 AM

Regina Davis, PhD, MPH, MCHES , Department of Family Science, University of Maryland, College Park, College Park, MD
Sandra Hofferth, PhD , Department of Family Science, University of Maryland, College Park, College Park, MD
Edmond D. Shenassa, ScD , Maternal & Child Health Program, department of Family Science, University of Maryland, College Park, MD
More than 28,000 U.S. babies die before their first birthday each year. Programmatic and Policy focus on prematurity and birth weight stem largely from their known relationship to infant mortality and morbidity. A large body of literature exists linking poor gestational weight gain to prematurity and low birth weight, but few studies have examined infant death as an important pregnancy outcome of inadequate gestational weight gain. As a measure of healthy gestational weight gain, the Institute of Medicine (IOM) published guidelines which provide a recommended weight gain for each category of pre-pregnancy Body Mass Index. Using data from the Pregnancy Risk Assessment Monitoring System in 35 states and New York City, we investigated the association between the 2009 IOM guidelines and infant death by maternal pre-pregnancy body mass index (BMI) among 160,111 women who delivered a singleton infant from 2004-2008. Descriptive and logistic regression analyses were used to assess the risk of infant mortality associated with inadequate gestational weight gain compared to normal weight gain. Nearly 25% of women experienced inadequate weight gain. Infants born to women with inadequate gestational weight gain had odds of infant death that were 1.61 times (p<0.0001, 95% Confidence Interval: 1.29, 1.99) the odds for infants born to women with normal weight gain. Increased odds remained after adjustment for gestational age, low birth weight, parity, maternal age, maternal education, prenatal care, maternal race, marital status, diabetes, hypertension, tobacco use, and alcohol consumption. There is a significant association between inadequate gestational weight gain and infant death.

Learning Areas:
Basic medical science applied in public health
Implementation of health education strategies, interventions and programs
Public health or related laws, regulations, standards, or guidelines
Public health or related research

Learning Objectives:
1. Identify the odds of infant mortality based on several demographic and medical risk factors. 2. Identify groups with the greatest risk of infant mortality in the presence of inadequate gestational weight gain. 3. Discuss the implications of the study findings for pregnant women's nutrition education. 4. Discuss the implications of the study findings in the context of the new 2009 Institute of Medicine (IOM) maternal weight gain recommendations.

Keywords: Infant Mortality, Pregnancy Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a public health researcher candidate specializing in Maternal and Child Health topic areas such as, women's reproductive health; maternal, infant, and child morbidity and mortality; disease prevention, and health education.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.