학술논문

Associations Between Rurality, pre-pregnancy Health Status, and Macrosomia in American Indian/Alaska Native Populations.
Document Type
Article
Source
Maternal & Child Health Journal. Dec2022, Vol. 26 Issue 12, p2454-2465. 12p. 1 Diagram, 2 Charts.
Subject
*FETAL macrosomia
*NATIVE Americans
*OBESITY
*MOTHERS
*SOCIAL determinants of health
*CONFIDENCE intervals
*ALASKA Natives
*POPULATION geography
*CHILD health services
*RESEARCH funding
*DESCRIPTIVE statistics
*GESTATIONAL diabetes
*BODY mass index
*MEDICAID
*DATA analysis software
*RURAL population
*MEDICAL care of indigenous peoples
*INSURANCE
*DISEASE complications
Language
ISSN
1092-7875
Abstract
Objectives: To examine the relationships between pre-pregnancy diabetes mellitus (DM), gestational diabetes mellitus (GDM), pre-pregnancy body mass index (BMI) and county-level social determinants of health, with infant macrosomia within a sample of American Indian/Alaska Native (AI/AN) women receiving Indian Health Service (IHS) care. Methods: The sample included women-infant dyads representing 1,136 singleton births from fiscal year 2011 (10/1/2019-9/30/2011). Data stemmed from the IHS Improving Health Care Delivery Data Project. Multivariate generalized linear mixed models were fitted to assess the association of macrosomia with pre-pregnancy health status and social determinants of health. Results: Nearly half of the women in the sample were under age 25 years (48.6%), and most had Medicaid health insurance coverage (76.7%). Of those with a pre-pregnancy BMI measure, 66.2% were overweight or obese. Although few women had pre-pregnancy DM (4.0%), GDM was present in 12.8% of women. Most women had a normal term delivery (85.4%). Overweight, obesity, pre-pregnancy DM, and county-level rurality were all significantly associated with higher odds of infant macrosomia. [ABSTRACT FROM AUTHOR]