Tipping the scale: Examining maternal pre-pregnancy obesity and infant mortality in the district of Columbia
Wednesday, November 6, 2013
Background: Historically, District of Columbia (DC) infant mortality rates were among the nation's worst. Maternal pre-pregnancy overweight and obesity increase risk for adverse pregnancy and birth outcomes, including infant death. This study investigated associations between maternal pre-pregnancy obesity and infant death rate disparities. Methods: Pre-pregnancy weight and height used to calculate body mass index (BMI), which determined normal (18.5-24.9kg/m2), overweight (25-29.9kg/m2), and obesity (30kg/m2 or greater). Risk factors including maternal race, ethnicity, age, education, supplemental nutrition program participation (WIC), prenatal care, delivery method, premature birth and birth weight category were analyzed with logistic regression using SAS version 9.3. Results: In 2011, 9,289 live births and 69 infant deaths occurred to DC residents, a substantial drop in infant mortality. Nearly 50% of infant deaths were among infants born to overweight or obese mothers. Among minorities, infant mortality was highest among obese non-Hispanic black mothers, however in Hispanics, infant mortality was highest among overweight mothers. Mothers with one unit greater BMI had 5% greater odds of infant death than mothers with lower BMI (OR=1.05, 95%CI 1.02-1.08). The crude odds of infant death among obese mothers was 2.21 as high as the odds among normal-weight mothers. Maternal BMI, WIC utilization, and very low birth weight categories were significant predictors (p<0.05) of infant death. Conclusions: Addressing maternal obesity and overall preconception health could improve infant mortality rates among high risk mothers in DC. Public health efforts to reduce infant mortality and adverse birth outcomes should incorporate reducing obesity in women of childbearing age.
Assess maternal obesity as a risk factor for infant mortality.
Evaluate disparities in infant mortality rate by maternal obesity and race, ethnicity, age, education level, and participation in supplemental nutrition programs.
Keyword(s): Infant Mortality, Obesity
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I completed a Masters in Public Health Nutrition from the University of Minnesota. Among my scientific interests has been the study of the effects of nutritional status on various health outcomes.
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.