Abstract
BackgroundParticipation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) has been associated with lower risk of stillbirth. We hypothesized that such an association would differ by race/ethnicity because of factors associated with WIC participation that confound the association.MethodsWe conducted a secondary analysis of the Stillbirth Collaborative Research Network’s population-based case-control study of stillbirths and live-born controls, enrolled at delivery between March 2006 and September 2008. Weighting accounted for study design and differential consent. Five nested models using multivariable logistic regression examined whether the WIC participation/stillbirth associations were attenuated after sequential adjustment for sociodemographic, health, healthcare, socioeconomic, and behavioral factors. Models also included an interaction term for race/ethnicity x WIC.ResultsIn the final model, WIC participation was associated with lower adjusted odds (aOR) of stillbirth among non-Hispanic Black women (aOR: 0.34; 95% CI 0.16, 0.72) but not among non-Hispanic White (aOR: 1.69; 95% CI: 0.89, 3.20) or Hispanic women (aOR: 0.91; 95% CI 0.52, 1.52).ConclusionsContrary to our hypotheses, control for potential confounding factors did not explain disparate findings by race/ethnicity. Rather, WIC may be most beneficial to women with the greatest risk factors for stillbirth. WIC-eligible, higher-risk women who do not participate may be missing the potential health associated benefits afforded by WIC.
Highlights
Participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) has been associated with lower risk of stillbirth
Non-random participation of women in WIC is a challenge in assessing the positive impact of WIC on birth outcomes because it is estimated that only two thirds of eligible pregnant or postpartum women participate in WIC [5]
We examined if the association between WIC and stillbirth was modified by race or ethnicity and if so, if these differences could be explained by factors associated with participation in WIC
Summary
Participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) has been associated with lower risk of stillbirth. We hypothesized that such an association would differ by race/ ethnicity because of factors associated with WIC participation that confound the association. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), established in the 1970’s in the United States, provides assistance in purchasing nutritious foods to pregnant and postpartum women and infants and children up to age five [1]. Non-random participation of women in WIC is a challenge in assessing the positive impact of WIC on birth outcomes because it is estimated that only two thirds of eligible pregnant or postpartum women participate in WIC [5]. WIC participation is associated with smoking during pregnancy among some women [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
