Lacci-Reilly Kandice R, Brunner Huber Larissa R
UNC Charlotte Department of Public Health Sciences, Charlotte, North Carolina, USA.
Birth. 2023 Mar;50(1):161-170. doi: 10.1111/birt.12700. Epub 2022 Dec 20.
Nearly 40% of pregnant women in 2016 were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Prior studies have investigated nutritional behaviors among WIC participants and access to WIC breastfeeding counseling services. However, there are no (few?) nationally representative, large-scale analyses of WIC users and pregnancy behaviors. Thus, the present study aims to examine associations between WIC use and select pregnancy outcomes among Medicaid enrollees.
We examined pregnancy-related behaviors and outcomes using 2018 U.S. Birth Certificates for Medicaid patients aged 18-45 years (N = 1 159 263). Outcomes included prenatal care (PNC) adequacy, breastfeeding initiation, cigarette use, and gestational weight gain. Standard binary and multinomial logistic regressions were used to estimate odds ratios (OR) and 95% confidence intervals (CIs).
After adjustment, WIC users had statistically significant increased odds of adequate PNC (adjusted OR [AOR] = 1.31 [95% CI 1.30, 1.32]), cigarette use (quit smoking during pregnancy 1.09 [1.07, 1.11]; smoked throughout pregnancy 1.16 [1.14, 1.18], and exceeding recommendations of weight gain 1.07 [1.06, 1.08]) compared with non-WIC users. WIC enrollees also experienced decreased odds of breastfeeding initiation (0.85 [0.85, 0.86]) compared with non-WIC users.
The study underscores the value of the WIC program in improving access to PNC. Yet, low-income women remain at risk for smoking during pregnancy and exceeding the recommended amount of weight gain. Breastfeeding initiation is lower than anticipated among WIC participants. Additional studies are needed to investigate WIC program efficacy.
2016年，近40%的孕妇参加了妇女、婴儿和儿童特别补充营养计划（WIC）。先前的研究调查了WIC参与者的营养行为以及获得WIC母乳喂养咨询服务的情况。然而，目前尚无（几乎没有？）对WIC使用者和怀孕行为进行的全国代表性大规模分析。因此，本研究旨在探讨WIC使用与医疗补助参保者中某些怀孕结局之间的关联。
我们使用2018年美国18至45岁医疗补助患者的出生证明（N = 1159263）来研究与怀孕相关的行为和结局。结局包括产前护理（PNC）充足性、开始母乳喂养、吸烟情况和孕期体重增加。使用标准二元和多项逻辑回归来估计比值比（OR）和95%置信区间（CI）。
调整后，与非WIC使用者相比，WIC使用者在获得充足PNC方面的优势具有统计学意义（调整后OR [AOR] = 1.31 [95%CI 1.30, 1.32]），在吸烟方面（孕期戒烟1.09 [1.07, 1.11]；整个孕期吸烟1.16 [1.14, 1.18]），以及在超过体重增加建议方面（1.07 [1.06, 1.08]）。与非WIC使用者相比，WIC参保者开始母乳喂养的几率也较低（0.85 [0.85, 0.86]）。
该研究强调了WIC计划在改善获得PNC方面的价值。然而，低收入女性在孕期吸烟和超过建议体重增加量方面仍面临风险。WIC参与者开始母乳喂养的比例低于预期。需要进一步研究来调查WIC计划的效果。
