Online Program

Relationship between maternal pre-pregnancy obesity and smokeless tobacco use and pre-term delivery and low birthweight among Palauan women

Tuesday, November 5, 2013 : 11:30 a.m. - 11:50 a.m.

Haley Cash, PhD, MPH, Department of Behavioral Health, Republic of Palau Ministry of Health, Koror, Palau
Katherine Berger, MD, School of Medicine, Oregon Health & Science University, Portland, OR
Background: Palau, like most other Pacific island nations is heavily burdened by obesity and tobacco use. Although both factors are known to be associated with adverse birth outcomes, little work has been done to examine these relationships in the Pacific. Methods: We conducted a retrospective cohort study on pregnant Palauan women and their infants from 2007-2013 (N=1171) using prenatal and delivery hospital records. Multivariate logistic regression assessed relationships between maternal pre-pregnancy obesity and smokeless tobacco use and pre-term delivery and low birthweight. Results: Overall, 76% of women reported chewing tobacco with betel nut during pregnancy, and 30% were obese prior to pregnancy. 106 infants (9%) born pre-term (<37 weeks), and 42 full-term (>=37 weeks) infants (4%) born low birthweight (<2500g). The odds of pre-term delivery were higher for women who were obese (BMI>=30) prior to pregnancy (aOR=1.6; 95%CI: 1.1-2.5) than women who were non-obese prior to pregnancy. The odds of delivering a full-term low birthweight infant were higher for women who chewed tobacco with betel nut during pregnancy (aOR=2.4; 95%CI: 1.0-6.0) than women with no tobacco or betel nut use during pregnancy. All models controlled for maternal age, parity, education, and marital status. Conclusion: Pre-pregnancy obesity was associated with increased risk of pre-term delivery; tobacco with betel nut chewing during pregnancy was associated with increased risk of low birthweight among full-term infants. These risk factors are highly prevalent among pregnant Palauan women, interventions should target these behaviors among young women in order to reduce adverse birth outcomes.

Learning Areas:

Clinical medicine applied in public health
Diversity and culture
Provision of health care to the public
Public health or related nursing

Learning Objectives:
Analyze the realtionship between obesity and tobacco use on birth outcomes among Palauan women Idenitfy risk factors for poor birth outcomes amenable to intervention

Keyword(s): Tobacco, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the behavioral epidemiologist for the ministry of health, Republic of Palau and served as PI for this project which was done by a summer intern student.
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.