Neighborhood racial composition and poverty in association with pre-pregnancy weight and gestational weight gain.
Neighborhood racial composition and poverty in association with pre-pregnancy weight and gestational weight gain.
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DOI：
10.1016/j.ssmph.2016.09.008
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发表时间：
2016-12
期刊：
影响因子：
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通讯作者：
Bodnar L
中科院分区：
文献类型：
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作者：
Mendez DD;Thorpe RJ;Amutah N;Davis EM;Walker RE;Chapple-McGruder T;Bodnar L
关于邻里种族构成或邻里贫困与怀孕相关体重的关系的研究很有限。先前对社区种族密度和贫困的研究与不良出生结果有关，并表明贫困率和黑人居民种族构成较高的社区通常被隔离并系统地与机会和资源隔绝。这些邻里因素可能有助于解释孕前体重和体重增加不足的种族差异。这项研究调查了社区种族构成和社区贫困是否与怀孕前体重和怀孕期间体重增加有关，以及这种关联是否因种族而异。我们使用了宾夕法尼亚州阿勒格尼县 73,061 名非西班牙裔黑人和白人女性单胎出生的重要出生记录（2003 年至 2010 年）。母亲的种族和民族、孕前体重指数（BMI）、妊娠体重增加和其他个人层面的特征均来自重要的出生记录数据，社区种族构成（社区中黑人居民的百分比）和贫困（社区中低于联邦贫困线的家庭百分比）的衡量标准则利用美国人口普查数据得出。采用多级对数二项式回归模型来估计与孕前体重（即超重/肥胖）和妊娠体重增加（即不足和过度）相关的社区种族构成和贫困。与白人女性相比，黑人女性在怀孕前更有可能超重/肥胖，并且妊娠期体重增加不足（分别为 53.6% vs. 38.8%；22.5% vs. 14.75）。与生活在白人为主的社区的黑人女性相比，生活在黑人为主的社区的黑人女性在怀孕前肥胖的可能性略高（PR 1.10；95% CI：1.03，1.16）。与生活在较低贫困地区的妇女相比，生活在高度贫困地区的黑人和白人妇女在怀孕前更有可能肥胖；与低贫困地区相比，只有生活在高贫困地区的白人妇女在怀孕期间体重增加的可能性更大。社区种族构成和贫困对于理解育龄妇女体重的种族差异可能很重要。与生活在白人为主的社区的黑人女性相比，生活在黑人为主的社区的黑人女性在怀孕前肥胖的可能性略高。与生活在低贫困地区的妇女相比，生活在高贫困地区的黑人和白人妇女在怀孕前更有可能肥胖。与低贫困地区相比，只有生活在高贫困地区的白人女性在怀孕期间体重增加的可能性更大。
Studies of neighborhood racial composition or neighborhood poverty in association with pregnancy-related weight are limited. Prior studies of neighborhood racial density and poverty has been in association with adverse birth outcomes and suggest that neighborhoods with high rates of poverty and racial composition of black residents are typically segregated and systematically isolated from opportunities and resources. These neighborhood factors may help explain the racial disparities in pre-pregnancy weight and inadequate weight gain. This study examined whether neighborhood racial composition and neighborhood poverty was associated with weight before pregnancy and weight gain during pregnancy and if this association differed by race. We used vital birth records of singleton births of 73,061 non-Hispanic black and white women in Allegheny County, PA (2003–2010). Maternal race and ethnicity, pre-pregnancy body-mass-index (BMI), gestational weight gain and other individual-level characteristics were derived from vital birth record data, and measures of neighborhood racial composition (percentage of black residents in the neighborhood) and poverty (percentage of households in the neighborhood below the federal poverty) were derived using US Census data. Multilevel log binomial regression models were performed to estimate neighborhood racial composition and poverty in association with pre-pregnancy weight (i.e., overweight/obese) and gestational weight gain (i.e., inadequate and excessive). Black women as compared to white women were more likely to be overweight/obese before pregnancy and to have inadequate gestational weight gain (53.6% vs. 38.8%; 22.5% vs. 14.75 respectively). Black women living in predominately black neighborhoods were slightly more likely to be obese prior to pregnancy compared to black women living in predominately white neighborhoods (PR 1.10; 95% CI: 1.03, 1.16). Black and white women living in high poverty areas compared with women living in lower poverty areas were more likely to be obese prior to pregnancy; while only white women living in high poverty areas compared to low poverty areas were more likely gain an inadequate amount of weight during pregnancy. Neighborhood racial composition and poverty may be important in understanding racial differences in weight among childbearing women. Black women living in predominately black neighborhoods were slightly more likely to be obese prior to pregnancy compared to black women living in predominately white neighborhoods. Black and white women living in high poverty areas compared with women living in lower poverty areas were more likely to be obese prior to pregnancy. Only white women living in high poverty areas compared to low poverty areas were more likely gain an inadequate amount of weight during pregnancy.