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Pre-pregnancy Weight and Racial-Ethnic Disparities in Pregnancy-Associated Conditions in the State of Georgia: A Population-Based Study

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Abstract

Introduction

We investigate racial-ethnic disparities in pre-pregnancy obesity and pregnancy weight gain, which are known to increase the risk of pregnancy-associated conditions.

Methods

We used 4-year (2017–2020) combined Georgia Pregnancy Risk Assessment Monitoring System data (N = 3208) to investigate racial-ethnic disparities in the incidence of gestational hypertension (GHT), gestational diabetes mellitus (GDM), and postpartum depression (PPD) and their associated risk with pre-pregnancy overweight/obesity after controlling for demographic and other confounders using regression modeling. The geographic distributions of hypertension and PPD rates at the county level were compared to the patterns of racial-ethnic populations and hospitals.

Results

The PPD rates were higher among Asian (17.6), Hispanic (14.4), and Black (14.3); GDM was highest among Asian (16.0) mothers; and GHT was the highest among Black (11.7) followed by White mothers (9.0). Pre-pregnancy overweight and obese conditions increased the odds of hypertension in Black (2 ½ times) and White (> 3 ½ times) mothers. Premature birth increased the odds of hypertension (2–3 times) in all mothers. Pre-pregnancy weight also increased the odds of GDM (3–7 times) in these racial groups. Premature birth increases the odds twice as likely for PPD in Hispanic and White mothers. The convergence of high PPD and hypertension rates with high proportions of racial and ethnic minorities, and lack of hospital presence, indicates areas where healthcare interventions are required.

Conclusions

These findings underscore the importance of promoting a healthy pre-pregnancy weight to reduce the burden of maternal morbidity and pregnancy outcomes in general. More comprehensive prenatal monitoring using technological interventions for self-care has a great promise of being effective in maintaining a healthy pregnancy.

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Data Availability

These data are protected, not available for public use.

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Authors and Affiliations

  1. Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, USA

    Suhasini Ramisetty-Mikler

  2. Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, USA

    Suhasini Ramisetty-Mikler

  3. Urban Life Building, Room 406, 140 Decatur St, Atlanta, GA, 30303, USA

    Suhasini Ramisetty-Mikler

  4. Department of Geosciences, Georgia State University, Atlanta, USA

    Angelique Willis & Chetan Tiwari

  5. Center for Disaster Informatics and Computational Epidemiology, Georgia State University, Atlanta, USA

    Chetan Tiwari

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  1. Suhasini Ramisetty-Mikler
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  3. Chetan Tiwari
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by SRM, AW, and CT. SRM wrote the first draft of the manuscript and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Suhasini Ramisetty-Mikler.

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Ethics Approval

This is an observational study performed in line with the principles of the Declaration of Helsinki. The study was approved under the category of “exemption” (for the use of secondary data) by the institutional review board ethics committee (Georgia State University - reference number H22352, 01/26/2022).

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The authors declare no competing interests.

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Ramisetty-Mikler, S., Willis, A. & Tiwari, C. Pre-pregnancy Weight and Racial-Ethnic Disparities in Pregnancy-Associated Conditions in the State of Georgia: A Population-Based Study. J. Racial and Ethnic Health Disparities (2024). https://doi.org/10.1007/s40615-024-01932-2

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