Racial differences in contribution of prepregnancy obesity and excessive gestational weight gain to large-for-gestational-age neonates

Yanfang Guo; Qun Miao; Tianhua Huang; Deshayne B Fell; Katherine Muldoon; Shi-Wu Wen; Mark C Walker; Laura M Gaudet

doi:10.1038/s41366-020-0543-5

Racial differences in contribution of prepregnancy obesity and excessive gestational weight gain to large-for-gestational-age neonates

Int J Obes (Lond). 2020 Jul;44(7):1521-1530. doi: 10.1038/s41366-020-0543-5. Epub 2020 Feb 19.

Authors

Yanfang Guo^#^{1

2

3

4}, Qun Miao^{5

6

7}, Tianhua Huang^{5

8

9}, Deshayne B Fell^{6

7}, Katherine Muldoon¹⁰, Shi-Wu Wen^{10

7

11}, Mark C Walker^{5

10

7

11}, Laura M Gaudet^#^{12

13

14

15}

Affiliations

¹ Better Outcomes Registry & Network Ontario, Ottawa, ON, Canada. yguo@bornontario.ca.
² Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada. yguo@bornontario.ca.
³ OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada. yguo@bornontario.ca.
⁴ School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada. yguo@bornontario.ca.
⁵ Better Outcomes Registry & Network Ontario, Ottawa, ON, Canada.
⁶ Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
⁷ School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
⁸ Genetics Program, North York General Hospital, Toronto, ON, Canada.
⁹ Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.
¹⁰ OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
¹¹ Department of Obstetrics, Gynecology, and Newborn Care, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
¹² OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada. Laura.Gaudet@kingstonhsc.ca.
¹³ School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada. Laura.Gaudet@kingstonhsc.ca.
¹⁴ Department of Obstetrics and Gynecology, Queen's University, Kingston, ON, Canada. Laura.Gaudet@kingstonhsc.ca.
¹⁵ Department of Obstetrics and Gynecology, Kingston Health Sciences Center, Kingston, ON, Canada. Laura.Gaudet@kingstonhsc.ca.

^# Contributed equally.

PMID: 32076106
DOI: 10.1038/s41366-020-0543-5

Abstract

Objectives: To examine the racial differences in the population attributable fraction (PAF) of prepregnancy obesity and excessive gestational weight gain to large-for-gestational-age (LGA) neonates.

Methods: We conducted a population-based retrospective cohort study among all women who had prenatal screening and had a singleton live birth in a hospital (1 April 2016-31 March 2017) using data from Ontario birth registry in Canada. We used multivariable log-binomial regression models to estimate the PAF and 95% confidence interval (CI) of LGA neonates due to prepregnancy obesity and excessive gestational weight gain. All models were stratified by race (White, Asian, and Black).

Results: Of the 74,402 eligible women, the prevalence of prepregnancy obesity, excessive gestational weight gain, and LGA neonate was 21.1%, 60.0%, and 11.3%, respectively, for Whites; 9.3%, 45.9%, and 5.4%, respectively, for Asians; and 28.6%, 52.4%, and 7.9%, respectively, for Blacks. The association of prepregnancy obesity was greater than that of excessive gestational weight gain on LGA for all racial groups. Excessive gestational weight gain contributed more than prepregnancy obesity in Whites (PAF 32.9%, 95% CI [30.3-35.5%] and 16.6%, 95% CI [15.3-17.9%], respectively, for excessive gestational weight gain and prepregnancy obesity) and in Asians (PAF 32.1%, 95% CI [27.2-36.7%] and 11.8%, 95% CI [9.5-14.1%], respectively, for excessive gestational weight gain and prepregnancy obesity). Prepregnancy obesity (PAF 22.8%, 95% CI [17.1-28.1%]) and excessive gestational weight gain (PAF 20.1%, 95% CI [4.7-33.0%]) contributed to LGA neonates almost the same in Blacks.

Conclusions: Excessive gestational weight gain contributed more to LGA neonates than prepregnancy obesity in Whites and Asians, while there was no difference between excessive gestational weight gain and prepregnancy obesity in their contributions to the LGA neonates in Blacks. The differences are mostly driven by the differential prevalence of the two risk factors across racial groups.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Asian People
Black People
Fetal Macrosomia / ethnology*
Gestational Weight Gain / ethnology*
Humans
Infant, Newborn
Obesity / ethnology*
Ontario
Prevalence
Race Factors*
Retrospective Studies
Risk Factors
White People
Young Adult

Grants and funding

FDN-148438/CIHR/Canada