title: Exploring potential health disparities in excessive gestational weight gain.
abstract: BACKGROUND
  Although previous public health efforts have focused on redressing health disparities associated with insufficient gestational weight gain, examination of the impact of excessive gestational weight gain is warranted currently given the 2009 revision of the Institute of Medicine (IOM) gestational weight gain guidelines for obese women coupled with rising rates of obesity, particularly among African American women.
  
  
  METHODS
  In the years 2004-2008, 4619 African American and Caucasian women gave birth to a single, live, and full-term infant, completed Arkansas Pregnancy Risk Assessment Monitoring System questions about gestational weight gain and prepregnancy weight status, and gained within or in excess of the guidelines. Logistic regression was used to identify sociodemographic and health variables associated with the odds of exceeding the 2009 IOM guidelines overall and by race.
  
  
  RESULTS
  Regardless of race, overweight (odds ratio [OR]=3.21; 95% confidence interval [CI]: 2.64-3.91) and obese (OR=4.37; 95% CI: 3.50-5.46) women had significantly higher odds of gaining excessively, as compared with normal weight women. In the multivariate model, women who were overweight or obese prepregnancy and who were married had higher odds of exceeding the IOM guidelines, while lower odds of exceeding the guidelines were seen among African American women, those who had Medicaid at any point in their pregnancy, who were multiparous, and those of Hispanic ethnicity.
  
  
  CONCLUSIONS
  These findings can inform efforts to promote appropriate gestational weight gain among those at highest risk (i.e., overweight/obese women) and facilitate targeting to produce greatest improvement in the health of mothers and children.
authors.affiliation: Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. rkrukows@uthsc.edu
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Krukowski
authors.forename: Zoran
authors.initials: Z
authors.lastname: Bursac
authors.forename: Mary A
authors.initials: MA
authors.lastname: McGehee
authors.forename: Delia
authors.initials: D
authors.lastname: West
mesh_terms: D000328:Adult; D001131:Arkansas; D001835:Body Weight / Q000208:ethnology / Q000502:physiology*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D050177:Overweight / Q000503:physiopathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D018570:Risk Assessment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D015430:Weight Gain / Q000208:ethnology / Q000502:physiology