Racial-ethnic differences in pregnancy-related weight

Abstract

This review examines published literature to answer 2 questions: 1) Are there racial-ethnic differences in excessive or inadequate gestational weight gain (GWG) and postpartum weight retention (PPWR)? and 2) Is there evidence that approaches to promote healthy weight during and after pregnancy should vary by race-ethnicity? We identified a limited number of articles that explicitly looked at racial-ethnic differences in either GWG or PPWR after controlling for relevant covariates. These studies suggest that black and Hispanic women are more likely to gain inadequately based on the Institute of Medicine's pregnancy weight gain guidelines compared to white women. Black women are more likely to retain considerable amounts of weight postpartum compared to both Hispanic and white mothers. Studies were inconclusive as to whether Hispanic women retained more or less weight postpartum, so more research is needed. Interventions to increase GWG were few and those designed to reduce GWG and PPWR showed mixed results. Future studies should address the methodological and conceptual limitations of prior research as well as investigate biological mechanisms and behavioral risk factors to determine the reasons for the racial-ethnic differences in pregnancy-related weight outcomes. Interventions would benefit from a mixed-methods approach that specifically identifies race-relevant barriers to weight management during and after pregnancy. Attention to the greater social context in which pregnancy-related weight exists is also needed.

Figure 1

Infant mortality rates by race-ethnicity, United States, 2000 and 2007. Source: Table B: Infant, neonatal, and postneonatal mortality rates, by race and Hispanic origin of mother: United States, 1995, 2000–2007 linked files. Federal Interagency Forum on Child and Family Statistics. America’s children: key national indicators of well-being, 2011. Washington, DC: U.S. Government Printing Office; 2011 [cited 2011 Aug 8]. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_06.pdf.

Figure 2

Percent low birth weight births by race-ethnicity, 2007. Source: Table 5. Percentage of live births with selected maternal and infant characteristics, by Hispanic origin of mother and race of mother for mothers of non-Hispanic origin: United States, 2007 linked file. Federal Interagency Forum on Child and Family Statistics. America’s children: key national indicators of well-being, 2011. Washington, DC: U.S. Government Printing Office; 2011 [cited 2011 Aug 8]. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_06.pdf.

Figure 3

Prevalence of high BMI among U.S. adolescent girls age 12–19 years old based on BMI percentile of CDC growth charts by race-ethnicity, 2003–2006. Source: Tables 2–8 (2). [Adapted with permission from (2)].

Figure 4

Trends in GWG based on 2009 IOM guidelines by race-ethnicity. Reproduced from (7).