Date of Award

2010

Document Type

Campus Access Thesis

Department

Epidemiology and Biostatistics

Sub-Department

Epidemiology

First Advisor

Myriam Torres

Abstract

Introduction:

Each year, an estimated 4 million babies are born in the United States. High blood pressure that occurs during pregnancy, otherwise known as gestational hypertension occurs in up to 10% of all pregnancies and may lead to more serious outcomes in both the mother and child. Previous literature has shown that excessive weight gain is a risk factor for gestational hypertension. Latinos are the largest minority in the United States and 1 in 5 babies born in the US are to Latina mothers. Only a small amount of literature is available regarding relationship between gestational hypertension and weight gain among Latinas.

Methods:

A cross-sectional study design used data from the 2004-2006 South Carolina birth certificates. Descriptive statistics examined basic demographics, outcomes, and exposures among Caucasians, African-Americans, Latinas, and Others. Logistic regression was used to assess the relationship between gestational hypertension and weight gain. The model adjusted for risk factors including BMI, age, marital status, smoking status, education level, adequacy of care, early gestational age, low birth weight, and parity. Secondary outcomes of gestational age and low birth weight were also examined to find out how gestational hypertension manifests itself.

Results:

After the exclusion criteria were met, there were 150,146 observations. The crude odds of gestational hypertension among women who gained excessive weight during pregnancy, or more weight than recommended by the Institute of Medicine guidelines, was 1.82 (95% CI: 1.72, 1.93) compared to those who gained the recommended weight. After adjustment for confounders, Latinas had an odds ratio of (OR = 1.75; 95% CI: 1.67, 1.83) for gestational hypertension. After stratification, the odds of gestational hypertension slightly decreased to 1.80 (95% CI: 1.41, 2.30) Among all women, the odds of preterm birth (OR = 2.42, 95% CI: 2.24, 2.61) and low birth weight (OR = 2.49, 95% CI: 2.33, 2.67) each significantly increase with exposure to gestational hypertension.

Conclusions:

Similar to previous literature, Latinas appear to be significantly affected by gestational hypertension as a result of excessive weight gain compared to their counterparts. It is also clear that gestational hypertension increases the odds of negative birth outcomes including preterm births and low birth weight. Future studies should examine this subject further in order to improve maternal and child birth outcomes.

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