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The Impact of Maternal Diabetes, Obesity and Race on Infant Birth Weights in South Dakota.

Abstract

INTRODUCTION

Maternal obesity, high gestational weight gain and diabetes mellitus during pregnancy are known risk factors that correlate with high infant birth weight and the mother's race. Previous studies have focused on low birth weight, prematurity and infant mortality. This study examined the interaction between race, maternal risk factors and high infant birth weights at the population level in South Dakota to identify factors contributing to the high Native American infant birth weights. We hypothesized that high infant birth weights were associated with maternal diabetes, obesity and high gestational weight gain, and that Native American infants' higher birth weights were related to the prevalence of diabetes and obesity.

MATERIALS AND METHODS

De-identified birth certificate data was provided by the South Dakota Department of Health. We used data for live infant births to South Dakota resident mothers from 2006 through 2011. The mothers were categorized as Native American or white by the mother's self-reported primary race. Infants were excluded from the study population for missing data, birth weight less than 350 g or gestational age less than 24 weeks or greater than 45 weeks. The study population included 11,416 Native American infants and 59,263 white infants for a total study population of 70,679 infants. Maternal variables (race, pre-pregnancy weight and body mass index [BMI], gestational weight gain, pre-pregnancy diabetes mellitus [DM], gestational diabetes [GDM] and delivery BMI) and infant variables (gestational age and birth weight) were analyzed using SPSS software.

RESULTS

The mean birth weight (BW) of Native American (NA) infants (3377 g) was significantly greater than the mean BW of white (W) infants (3315 g) even though NA infants had a younger mean gestational age (p = 0.006). More NA infants were categorized as high birth weight (HBW) (11.8 percent) than W infants (8.5 percent). Both DM and GDM were significantly more common among NA mothers. Infants of NA mothers with GDM had a higher mean BW than infants of W mothers with GDM. There were more overweight and obese NA mothers (p = 0.006). In each maternal BMI category, NA infants had a higher mean BW. Mean BW was even higher for infants born to mothers with excessive gestational weight gain (GWG) for their BMI. The infants with the highest mean BW were born to obese NA mothers with GDM and excessive GWG (3680 g). Multivariable linear regression showed that race was the most significant variable affecting infant BW (R2 = 0.57, F = 692). Pre-pregnancy BMI, GWG and excessive GWG were also significant. The most significant interaction variables were race and GDM and race and BMI.

CONCLUSIONS

Native American race, gestational diabetes mellitus, overweight and obese BMI, and excessive gestational weight gain for BMI were the most significant maternal factors associated with high infant birth weight. Mothers with any one risk factor gave birth to heavier infants. Mothers with all risk factors had infants with the highest mean birth weights in South Dakota. This large population-based study provides evidence that Native American mothers in South Dakota with GDM, overweight or obese BMI and excessive GWG are more likely to give birth to high birth weight infants. At-risk mothers should be educated regarding the risks and potential complications of high birth weight infants.

Links

Authors+Show Affiliations

,

University of Minnesota, North Memorial Family Medicine Residency.

,

University of South Dakota Sanford School of Medicine.

,

South Dakota Department of Health.

Sanford Children's Hospital, Neonatal Intensive Care Unit. Department of Pediatrics, University of South Dakota Sanford School of Medicine.

Source

MeSH

Birth Certificates
Birth Weight
Cross-Sectional Studies
Diabetes, Gestational
European Continental Ancestry Group
Female
Gestational Age
Humans
Indians, North American
Infant, Newborn
Overweight
Pregnancy
Pregnancy in Diabetics
South Dakota

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28810088

Citation

Halvorson, Kari L., et al. "The Impact of Maternal Diabetes, Obesity and Race On Infant Birth Weights in South Dakota." South Dakota Medicine : the Journal of the South Dakota State Medical Association, vol. 70, no. 2, 2017, pp. 61-66.
Halvorson KL, Vogt HB, Kightlinger L, et al. The Impact of Maternal Diabetes, Obesity and Race on Infant Birth Weights in South Dakota. S D Med. 2017;70(2):61-66.
Halvorson, K. L., Vogt, H. B., Kightlinger, L., & Stevens, D. (2017). The Impact of Maternal Diabetes, Obesity and Race on Infant Birth Weights in South Dakota. South Dakota Medicine : the Journal of the South Dakota State Medical Association, 70(2), pp. 61-66.
Halvorson KL, et al. The Impact of Maternal Diabetes, Obesity and Race On Infant Birth Weights in South Dakota. S D Med. 2017;70(2):61-66. PubMed PMID: 28810088.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Impact of Maternal Diabetes, Obesity and Race on Infant Birth Weights in South Dakota. AU - Halvorson,Kari L, AU - Vogt,H Bruce, AU - Kightlinger,Lon, AU - Stevens,Dennis, PY - 2017/8/16/entrez PY - 2017/8/16/pubmed PY - 2017/11/29/medline SP - 61 EP - 66 JF - South Dakota medicine : the journal of the South Dakota State Medical Association JO - S D Med VL - 70 IS - 2 N2 - INTRODUCTION: Maternal obesity, high gestational weight gain and diabetes mellitus during pregnancy are known risk factors that correlate with high infant birth weight and the mother's race. Previous studies have focused on low birth weight, prematurity and infant mortality. This study examined the interaction between race, maternal risk factors and high infant birth weights at the population level in South Dakota to identify factors contributing to the high Native American infant birth weights. We hypothesized that high infant birth weights were associated with maternal diabetes, obesity and high gestational weight gain, and that Native American infants' higher birth weights were related to the prevalence of diabetes and obesity. MATERIALS AND METHODS: De-identified birth certificate data was provided by the South Dakota Department of Health. We used data for live infant births to South Dakota resident mothers from 2006 through 2011. The mothers were categorized as Native American or white by the mother's self-reported primary race. Infants were excluded from the study population for missing data, birth weight less than 350 g or gestational age less than 24 weeks or greater than 45 weeks. The study population included 11,416 Native American infants and 59,263 white infants for a total study population of 70,679 infants. Maternal variables (race, pre-pregnancy weight and body mass index [BMI], gestational weight gain, pre-pregnancy diabetes mellitus [DM], gestational diabetes [GDM] and delivery BMI) and infant variables (gestational age and birth weight) were analyzed using SPSS software. RESULTS: The mean birth weight (BW) of Native American (NA) infants (3377 g) was significantly greater than the mean BW of white (W) infants (3315 g) even though NA infants had a younger mean gestational age (p = 0.006). More NA infants were categorized as high birth weight (HBW) (11.8 percent) than W infants (8.5 percent). Both DM and GDM were significantly more common among NA mothers. Infants of NA mothers with GDM had a higher mean BW than infants of W mothers with GDM. There were more overweight and obese NA mothers (p = 0.006). In each maternal BMI category, NA infants had a higher mean BW. Mean BW was even higher for infants born to mothers with excessive gestational weight gain (GWG) for their BMI. The infants with the highest mean BW were born to obese NA mothers with GDM and excessive GWG (3680 g). Multivariable linear regression showed that race was the most significant variable affecting infant BW (R2 = 0.57, F = 692). Pre-pregnancy BMI, GWG and excessive GWG were also significant. The most significant interaction variables were race and GDM and race and BMI. CONCLUSIONS: Native American race, gestational diabetes mellitus, overweight and obese BMI, and excessive gestational weight gain for BMI were the most significant maternal factors associated with high infant birth weight. Mothers with any one risk factor gave birth to heavier infants. Mothers with all risk factors had infants with the highest mean birth weights in South Dakota. This large population-based study provides evidence that Native American mothers in South Dakota with GDM, overweight or obese BMI and excessive GWG are more likely to give birth to high birth weight infants. At-risk mothers should be educated regarding the risks and potential complications of high birth weight infants. SN - 0038-3317 UR - https://www.unboundmedicine.com/medline/citation/28810088/The_Impact_of_Maternal_Diabetes_Obesity_and_Race_on_Infant_Birth_Weights_in_South_Dakota_ L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -