Analyzing the Relationships of Healthy Start Women's Weight, BMI and Maternal & Child Health Outcomes and the Healthy Start Healthy Women Project in Pittsburgh, Pennsylvania

PURPOSE: Healthy Start, Inc. (HSI), as a member of the Health Resources & Services Administration's (HRSA) Interconceptional Care Learning Collaborative (ICCLC), selected Healthy Weights in Women. Research suggests that maternal weight is associated with birth outcomes. HSI in Pittsburgh, PA is community-based, with no affiliation to a medical facility. Body Mass Index (BMI) calculations are based on self-reporting of the mother. Accuracy from the mother reporting and the staff members assessing is biased. DESIGN METHODS: HSI conducted an analysis of 796 enrolled women, mostly African American, from January 2009 - December 2010. Self-reported pre-pregnancy BMIs were compared to birth outcomes and infant deaths: 52% were overweight; 64% of infant deaths were to overweight/obese mothers; Overweight/Obese mothers had more very low weight births (3%); Underweight women had the majority of preterm births (19%). RESULTS: HSI developed the Healthy Start, Healthy Women Program (HSHW). HSHW aims to improve knowledge of healthy lifestyles for staff/participants, measure BMIs, reduce bias, use home visiting to educate, and evaluate effectiveness. From April-August 2011, 91 women enrolled into HSHW. BMI measurements and education on healthy eating and lifestyle management were conducted in the homes. CONCLUSION: Personal/cultural perceptions of weight vary among staff members and participants. Weight management is a necessary component of the Healthy Start model and contributes to birth outcomes. Program strategies should be implemented early and considered part of preconception and life course methods. Strategies should include, rather than exclude, persons in the normal BMI range.