Obesity, Diet Quality, Neighborhood Socioeconomics, and Risk for Adverse Pregnancy Outcomes Among Black Women

Obesity, poor diet quality, and low neighborhood socioeconomic status (nSES) are individual and inter-related risk factors for adverse pregnancy outcomes (APOs) that disproportionately affect Black women. Yet, studies of APOs among Black women typically focus only on obesity, which may obfuscate the importance of nSES and diet quality to APOs. Hence, this study examines the associations of APOs with obesity (BMI ≥ 30kg/m2), diet quality, and nSES among Black pregnant women. Secondary analysis of Black women from a prospective cohort study. The Dietary Health Questionnaire II was administered in the 3rd trimester or postpartum. Diet quality was assessed by the 2015 Healthy Eating Index. NSES was stratified into high and low using the Area Deprivation and Social Vulnerability indices. Multivariable logistic regression was used to estimate the association of obesity, dietary intake, and SES with APOs, including gestational diabetes, hypertensive disorders, fetal growth restriction, preterm birth, placental abruption, or stillbirth. Of 356 participants (age 25 ± 5 years; BMI: 30.75 ± 9.15 kg/m2), 145 (40.73%) had APOs. Independently, obesity (aOR= 1.66; 1.08, 2.54) and low nSES (aOR=1.60; 1.00, 2.51) were associated with APOs. However, after accounting for nSES (aOR=1.67; 1.04, 2.67), obesity (aOR=1.48; 0.92, 2.37) was no longer significant. The low nSES group had lower diet quality with more red meat (p=0.01) and added sugars (p< 0.01) than the high nSES group. Further, among those with low nSES, APOs were associated with higher intake of sodium (aOR = 1.51; 1.14, 2.01), protein (aOR = 1.30; 1.08, 1.58), and saturated fat (aOR = 1.15; 1.04, 1.29), independent of obesity. Diet quality and nSES, which likely reflect access to quality food, may be more important risk factors for APOs than obesity among Black women. Improving diet quality by reducing red meat, added sugars, sodium, and saturated fat may reduce disparate rates of APOs among Black women with low nSES.View Large Image Figure ViewerDownload Hi-res image Download (PPT)