title: The Effects of Race and Ethnicity on the Risk of Large-for-Gestational-Age Newborns in Women Without Gestational Diabetes by Prepregnancy Body Mass Index Categories.
abstract: Objectives Children born large for gestational age (LGA) are at risk of numerous adverse outcomes. While the racial/ethnic disparity in LGA risk has been studied among women with Gestational Diabetes Mellitus (GDM), the independent effect of race on LGA risk by maternal prepregnancy BMI is still unclear among women without GDM. Therefore, the objective of this study was to assess the association between maternal race/ethnicity and LGA among women without GDM. Methods This was a population-based cohort study of 2,842,278 singleton births using 2012 U.S. Natality data. We conducted bivariate and multivariate logistic regression analyses to assess the association between race and LGA. Due to effect modification by maternal prepregnancy BMI, we stratified our analysis by four BMI subgroups. Results The prevalence of LGA was similar across the different racial/ethnic groups at about 9%, but non-Hispanic Asian Americans had slightly higher prevalence of 11%. After controlling for potential confounders, minority women had higher odds of birthing LGA babies compared to non-Hispanic white women. Non-Hispanic Asian Americans had the highest odds of LGA babies across all BMI categories: underweight (aOR = 2.67; 95% CI: 2.24, 3.05); normal weight (aOR = 2.53; 2.43, 2.62); overweight (aOR = 2.45; 2.32, 2.60) and obese (aOR = 2.05; 1.91, 2.20). Conclusions for practice Racial/ethnic disparities exist in LGA odds, particularly among women with underweight or normal prepregnancy BMI. Most minorities had higher LGA odds than non-Hispanic white women regardless of prepregnancy BMI category. These racial/ethnic disparities should inform public health policies and interventions to address this problem.
authors.affiliation: Department of Epidemiology, College for Public Health and Social Justice, St. Louis University, 3545 Lafayette Ave, Saint Louis, MO, 63104, USA. tutlamnt@slu.edu.|Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, Saint Louis, MO, USA. tutlamnt@slu.edu.
authors.forename: Nhial T
authors.initials: NT
authors.lastname: Tutlam
authors.affiliation: Department of Epidemiology, College for Public Health and Social Justice, St. Louis University, 3545 Lafayette Ave, Saint Louis, MO, 63104, USA.
authors.forename: Yun
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Epidemiology, College for Public Health and Social Justice, St. Louis University, 3545 Lafayette Ave, Saint Louis, MO, 63104, USA.
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Nelson
authors.affiliation: Department of Epidemiology, College for Public Health and Social Justice, St. Louis University, 3545 Lafayette Ave, Saint Louis, MO, 63104, USA.
authors.forename: Louise H
authors.initials: LH
authors.lastname: Flick
authors.affiliation: Department of Epidemiology, College for Public Health and Social Justice, St. Louis University, 3545 Lafayette Ave, Saint Louis, MO, 63104, USA.
authors.forename: Jen Jen
authors.initials: JJ
authors.lastname: Chang
mesh_terms: D000328:Adult; D044466:Asian People; D001724:Birth Weight; D044383:Black People; D015992:Body Mass Index; D015331:Cohort Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology / Q000208:ethnology*; D005865:Gestational Age; D006630:Hispanic or Latino; D006801:Humans; D007231:Infant, Newborn; D009765:Obesity / Q000453:epidemiology / Q000208:ethnology; D011159:Population Surveillance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000208:ethnology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American
keywords: Birthweight percentiles; Gestational diabetes; Large for gestational age; Maternal race; New born; Prepregnancy body mass index