Abstract
ObjectiveTo explore inadequate and excessive gestational weight gain (GWG) among pregnant women of different racial/ethnic backgrounds in Ontario, Canada.MethodsA population-based retrospective cohort study was conducted among women who had prenatal screening and had a singleton birth in an Ontario hospital between April 2016 and March 2017. We estimated adjusted risk ratios (aRR) of racial/ethnic differences for inadequate or excessive GWG using multinomial logistic regression models. Interaction effects were examined to determine whether racial/ethnic difference in GWG varied by pre-pregnancy body mass index (BMI).ResultsAmong 74,424 women, the prevalence of inadequate GWG in White, Asian, and Black women was 15.7%, 25.8%, and 25.0%, and excessive GWG was 62.8%, 45.5%, and 54.7%, respectively. There were significant interaction effects between race/ethnicity and pre-pregnancy BMI for inadequate GWG (Wald p < 0.01) and excessive GWG (Wald p < 0.01). Compared with White women, Asian women had higher risk of inadequate GWG and lower risk of excessive GWG in all weight classes, and Black women had higher risk of inadequate GWG and lower risk of excessive GWG if their BMI was normal, overweight, or obese.ConclusionVariations in unhealthy GWG by pre-pregnancy weight classes among Ontario White, Asian and Black women were observed. Individualized counseling regarding appropriate GWG is universally recommended. Additional consideration of racial/ethnic variations by maternal weight classes may help to promote healthy GWG in Canada.
Highlights
Inadequate and excessive gestational weight gain (GWG) have both been linked with a number of adverse maternal and neonatal outcomes, which in turn vary by race/ ethnicity (Headen et al 2012)
Compared with White women, Black women were more likely to be obese, more likely to reside in a neighbourhood in the lowest income quintile, and less likely to smoke during pregnancy
The prevalence of inadequate GWG was higher in Asian (25.8%) and Black women (25.0%) than in White women (15.7%)
Summary
Inadequate and excessive gestational weight gain (GWG) have both been linked with a number of adverse maternal and neonatal outcomes, which in turn vary by race/ ethnicity (Headen et al 2012). Previous studies have reported racial/ethnic differences in GWG, with visible minorities at increased risk of inadequate GWG and lower risk of excessive GWG (Headen et al 2015; Kinnunen et al 2016; Pawlak et al 2015; Bahadoer et al 2015). Most of the population-based studies on racial/ethnic differences in GWG were conducted in the USA or Europe, and only two small studies have been performed in Canada (Kowal et al 2012; Larouche et al 2010). In Canada, only 3.5% of the total population identify as Black, and 17.7% identify as Asian which comprise the largest and fastest-growing visible minority group in Canada (Statistics Canada 2017). Fourth, limited studies considered interaction effects between race/ethnicity and pre-pregnancy body mass index (BMI) on GWG, studies indicated racial/ethnic disparities in pre-pregnancy BMI (Headen et al 2015; Liu et al 2014)
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