Goal Weight Trends Among Navajo Nation Prenatal Women and Prevention of Cardiovascular Disease in Postpartum Women: A Comparison Between 1994–1996

Abstract

Obstetric complications including prolonged labor, pregnancy-induced hypertension, gestational diabetes and thromboembolism can lead to long term cardiovascular disease if rate of weight gain and total weight gain is not monitored during pregnancy. The 1994 CDC Pregnancy Nutrition Surveillance System for the Navajo Nation WIC Program identified the pre-pregnancy weight status as 20% overweight and 25% very overweight in prenatal women. In 1995, the pre-pregnancy weight status was 19.5% overweight and 24.6% very overweight in prenatal women. During 1996, the pre-pregnancy weight status was 18.8% overweight and 30.6% very overweight. Within NNWIC clinics, the prevalence of overweight increased as the mother's age increased. Over the last three years. the data were as follows: 1994: age: 16–19, 22.5%; age: 20–29, 43%; age: 30–39, 60%; age: 40–49, 63.5% 1995: age: 16–19, 21.7%; age: 20–29, 43%; age: 30–39, 56.7%;age: 40–49, 68.9% 1996: age: 16–19, 8.7%; age: 20–29, 50%; age: 30–39, 36%; age: 40–49, Not Available. These percentages include overweight and very overweight categories (BMI>26). Since the baseline percentage of Native American/Alaska Natives for prevalence of overweight was between 29-75% which were estimates of different tribes, Year 2000 objective was initially set for 30% reduction. However, the NN WIC program's Year 2000 objective follows the Year 2000 objective for low-income women aged 20 and older where 1976–1989 baseline was 37% overweight prevalence with the objective for Year 2000 target <25%. Significant decreases were apparent in the 16–19 year old women as well as in the 30–39 year old women. However, significant increases were noted in the 20–29 year old women as well as the 40–49 year old women with data missing for this last age category. During 1995, Navajo specific prenatal nutrition education material promoting a healthy weight gain with appropriate dietary recommendations were developed and introduced The authors believe some of this intervention assisted in the decreases. However, since the very overweight has increased by 7% in the 20–29 year olds and 5.4% in the 40–49 year olds since 1994, more nutrition awareness and education is evident. Focused nutrition messages for the working and older prenatal and postpartum NNWIC participant were developed and introduced to the para-professionals and nutritionists. Since pre-pregnancy overweight is thought to be a risk factor for postpartum retention of prenatal gain as well as placing a postpartum woman at cardiovascular risk, heart healthy messages for a healthy weight were also developed which focused on changes in lifestyle, dietary practices, exercise habits, eating on the run and behavioral responses.