Mendez Dara D, Doebler Donna Almario, Kim Kevin H, Amutah Ndidi N, Fabio Anthony, Bodnar Lisa M
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, 15261, USA,
Matern Child Health J. 2014 Jul;18(5):1095-103. doi: 10.1007/s10995-013-1339-1.
We explored the relationship between neighborhood socioeconomic disadvantage (NSED) and gestational weight gain and loss and if the association differed by race. A census tract level NSED index (categorized as low, mid-low, mid-high, and high) was generated from 12 measures from the 2000 US Census data. Gestational weight gain and other individual-level characteristics were derived from vital birth records for Allegheny County, PA for 2003-2010 (n = 55,608). Crude and adjusted relative risks were estimated using modified multilevel Poisson regression models to estimate the association between NSED and excessive and inadequate gestational weight gain (GWG) and weight loss (versus adequate GWG). Black women lived in neighborhoods that were more likely to be socioeconomically disadvantaged compared to white women. Almost 55% of women gained an excessive amount of weight during pregnancy, and 2% lost weight during pregnancy. Black women were more likely than white women to have inadequate weight gain or weight loss. Mid-high (aRR = 1.3, 95% CI 1.2, 1.3) and high (aRR = 1.5, 95% CI 1.5, 1.6) NSED compared to low NSED was associated with inadequate weight gain while NSED was not associated with excessive weight gain. Among black women, high versus low NSED was associated with weight loss during pregnancy (RR = 1.6, 95% CI 1.1, 2.5). Among white women, each level of NSED compared to low NSED was associated with weight loss during pregnancy. This study demonstrates how neighborhood socioeconomic characteristics can contribute to our understanding of inadequate weight gain and weight loss during pregnancy, having implications for future research and interventions designed to advance pregnancy outcomes.
我们探讨了社区社会经济劣势（NSED）与孕期体重增减之间的关系，以及这种关联是否因种族而异。根据2000年美国人口普查数据中的12项指标生成了一个普查区层面的NSED指数（分为低、中低、中高和高）。孕期体重增加及其他个体层面特征来自宾夕法尼亚州阿勒格尼县2003 - 2010年的出生记录（n = 55,608）。使用改良的多水平泊松回归模型估计粗相对风险和调整后的相对风险，以评估NSED与孕期体重增加过多、不足以及体重减轻（相对于适当的孕期体重增加）之间的关联。与白人女性相比，黑人女性居住的社区更有可能在社会经济方面处于劣势。近55%的女性在孕期体重增加过多，2%的女性在孕期体重减轻。黑人女性比白人女性更有可能体重增加不足或体重减轻。与低NSED相比，中高（aRR = 1.3，95% CI 1.2, 1.3）和高（aRR = 1.5，95% CI 1.5, 1.6）NSED与体重增加不足相关，而NSED与体重增加过多无关。在黑人女性中，高NSED与低NSED相比与孕期体重减轻有关（RR = 1.6，95% CI 1.1, 2.5）。在白人女性中，与低NSED相比，每个NSED水平都与孕期体重减轻有关。这项研究表明社区社会经济特征如何有助于我们理解孕期体重增加不足和体重减轻，对未来旨在改善妊娠结局的研究和干预措施具有启示意义。
