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. 2016 Jul;24(7):1590-8.
doi: 10.1002/oby.21532. Epub 2016 May 25.

The Impact of maternal obesity and race/ethnicity on perinatal outcomes: Independent and joint effects

Jonathan M Snowden  1   2 , John F Mission  3 , Nicole E Marshall  1 , Brian Quigley  1 , Elliott Main  4 , William M Gilbert  5 , Judith H Chung  6 , Aaron B Caughey  1
Affiliations

The Impact of maternal obesity and race/ethnicity on perinatal outcomes: Independent and joint effects

Jonathan M Snowden et al. Obesity (Silver Spring). 2016 Jul.

Abstract

Objective: Independent and joint impacts of maternal race/ethnicity and obesity on adverse birth outcomes, including pre-eclampsia, low birth weight, and macrosomia, were characterized.

Methods: Retrospective cohort study of all 2007 California births was conducted using vital records and claims data. Maternal race/ethnicity and maternal body mass index (BMI) were the key exposures; their independent and joint impact on outcomes using regression models was analyzed.

Results: Racial/ethnic minority women of normal weight generally had higher risk as compared with white women of normal weight (e.g., African-American women, pre-eclampsia adjusted odds ratio [aOR] 1.60, 95% confidence interval [CI]: 1.48-1.74 vs. white women). However, elevated BMI did not usually confer additional risk (e.g., pre-eclampsia aOR comparing African-American women with excess weight with white women with excess weight, 1.17, 95% CI: 0.89-1.54). Obesity was a risk factor for low birth weight only among white women (excess weight aOR, 1.24, 95% CI: 1.04-1.49 vs. white women of normal weight) and not among racial/ethnic minority women (e.g., African-American women, 0.95, 95% CI: 0.83-1.08).

Conclusions: These findings add nuance to our understanding of the interplay between maternal race/ethnicity, BMI, and perinatal outcomes. While the BMI/adverse outcome gradient appears weaker in racial/ethnic minority women, this reflects the overall risk increase in racial/ethnic minority women of all body sizes.

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Figures

Figure 1
Figure 1
Unadjusted prevalence of adverse birth outcomes by BMI category, stratified by maternal race/ethnicity
Figure 1
Figure 1
Unadjusted prevalence of adverse birth outcomes by BMI category, stratified by maternal race/ethnicity
Figure 1
Figure 1
Unadjusted prevalence of adverse birth outcomes by BMI category, stratified by maternal race/ethnicity
See this image and copyright information in PMC

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