Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minnesota.
Minnesota Department of Health, St Paul, Minnesota.
Womens Health Issues. 2023 Nov-Dec;33(6):636-642. doi: 10.1016/j.whi.2023.07.001. Epub 2023 Aug 4.
Despite research showing substantial weight disparities along the rural-urban continuum, little work has attempted to identify differences in prepregnancy weight status or gestational weight gain (GWG) outcomes between rural and urban birthing people. As such, the goals of this research were to 1) document the prevalence of prepregnancy overweight and obesity and excessive GWG in rural and urban birthing people and 2) examine changes in rural and urban prepregnancy overweight or obesity and excessive GWG over time.
Birth certificate data provided sociodemographic variables, prepregnancy body mass index, GWG, and rurality status on 465,709 respondents who gave birth in Minnesota from 2012 to 2019. A series of regression models estimated risk differences in 1) prepregnancy weight status and 2) excessive GWG between rural and urban respondents over time, controlling for relevant covariates.
Rural individuals had a 4.9 percentage-point (95% confidence interval, 4.5-5.3) higher risk of having prepregnancy overweight or obesity compared with urban individuals, and a 2.6 percentage-point (95% confidence interval, 1.9-3.3) higher risk of gaining excessive gestational weight. The disparities in prepregnancy overweight or obesity and excessive gestational weight between rural and urban individuals widened over time.
These findings contribute to accumulating evidence documenting notable health disparities between rural and urban individuals during the perinatal period and support the need to develop prevention and treatment efforts focused on improving the weight-related health of individuals living in rural communities.
尽管有研究表明，在农村-城市连续体上存在着相当大的体重差异，但很少有研究试图确定农村和城市分娩人群之间的孕前体重状况或妊娠体重增加（GWG）结果的差异。因此，这项研究的目的是：1）记录农村和城市分娩人群中孕前超重和肥胖以及 GWG 过多的流行情况；2）检查农村和城市地区孕前超重或肥胖以及 GWG 随时间的变化情况。
出生证明数据提供了社会人口统计学变量、孕前体重指数、GWG 和农村或城市的生育状况，涵盖了 2012 年至 2019 年期间在明尼苏达州分娩的 465709 名受访者。一系列回归模型估计了农村和城市受访者在孕前体重状况和 GWG 过多方面的风险差异，同时控制了相关的协变量。
与城市个体相比，农村个体有 4.9%（95%置信区间，4.5-5.3）的更高风险患有孕前超重或肥胖，且有 2.6%（95%置信区间，1.9-3.3）的更高风险获得 GWG 过多。农村和城市个体之间在孕前超重或肥胖以及 GWG 过多方面的差异随着时间的推移而扩大。
这些发现有助于积累证据，证明在围产期期间农村和城市个体之间存在显著的健康差异，并支持需要制定以改善居住在农村社区的个体的体重相关健康为重点的预防和治疗措施。
