Associations Between Rurality, pre-pregnancy Health Status, and Macrosomia in American Indian/Alaska Native Populations

Vanessa Y Hiratsuka; Margaret Reid; Jenny Chang; Luohua Jiang; Angela G Brega; Amber L Fyfe-Johnson; Kimberly R Huyser; Michelle Johnson-Jennings; Cheryl Conway; John F Steiner; Jennifer Rockell; Denise A Dillard; Kelly Moore; Spero M Manson; Joan O'Connell

doi:10.1007/s10995-022-03536-w

Associations Between Rurality, pre-pregnancy Health Status, and Macrosomia in American Indian/Alaska Native Populations

Matern Child Health J. 2022 Dec;26(12):2454-2465. doi: 10.1007/s10995-022-03536-w. Epub 2022 Nov 8.

Authors

Vanessa Y Hiratsuka^{1

2}, Margaret Reid³, Jenny Chang⁴, Luohua Jiang⁵, Angela G Brega⁶, Amber L Fyfe-Johnson⁷, Kimberly R Huyser⁸, Michelle Johnson-Jennings⁹, Cheryl Conway¹⁰, John F Steiner¹¹, Jennifer Rockell¹², Denise A Dillard¹³, Kelly Moore¹⁴, Spero M Manson¹⁴, Joan O'Connell¹⁵

Affiliations

¹ Research Department, Southcentral Foundation, 4501 Diplomacy Drive, 99508, Anchorage, AK, USA. vyhiratsuka@alaska.edu.
² Center for Human Development, University of Alaska Anchorage, 3211 Providence Drive, 99508, 99504, Anchorage, AK, USA. vyhiratsuka@alaska.edu.
³ Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Denver, Denver, USA.
⁴ Department of Medicine, School of Medicine, University of California, 301 Medical Surge II, 92697-7550, Irvine, CA, USA.
⁵ Department of Epidemiology, University of California, Irvine, 3076 AIRB, 92697-7550, Irvine, CA, USA.
⁶ School of Public Health, Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, 13055 East 17th Avenue, 80045, Aurora, Colorado, CO, USA.
⁷ Institute for Research and Education to Advance Community Health (IREACH), Department of Medical Education and Clinical Sciences, Washington State University, 1100 Olive Way, Ste 1200, 98101, Seattle, WA, USA.
⁸ Department of Sociology, The University of British Columbia, Vancouver, USA.
⁹ Canada Research Chair for Indigenous Community Engaged Research for Indigenous Community Engaged Research, LE Clinical Health Psychologist, University of Saskatchewan, University of Colorado- Associate Professor, University of Washington- Associate Professor, Washington, USA.
¹⁰ NE-BC; Quality Consultant, Charles George Veterans Medical Center, Asheville, NC, USA.
¹¹ Institute for Health Research, Department of Medicine, Kaiser Permanente Colorado, University of Colorado Anschutz Medical Campus, Aurora, USA.
¹² Telligen, Inc. Greenwood Village, 7730 E. Belleview Ave Suite 300 Greenwood, 80111, Village, CO, USA.
¹³ Research Department, Southcentral Foundation, 4501 Diplomacy Drive, 99508, Anchorage, AK, USA.
¹⁴ Centers for American Indian and Alaska Native Health, University of Colorado, Anschutz Medical Campus, Mail Stop F800, 13055 E. 17th Avenue, 80045, Aurora, CO, USA.
¹⁵ Colorado School of Public Health, Centers for American Indian and Alaska Native Health, University of Colorado, Anschutz Medical Campus, Mail Stop F800, 13055 E. 17th Avenue, 80045, Aurora, CO, USA.

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.

Keywords: American Indians/Alaska Natives; Diabetes; Infant weight; Maternal child health; Obesity.

MeSH terms

Adult
Alaska Natives*
American Indian or Alaska Native
Birth Weight
Body Mass Index
Diabetes, Gestational* / epidemiology
Female
Fetal Macrosomia / epidemiology
Health Status
Humans
Infant
Obesity
Overweight
Pregnancy
Weight Gain

Abstract

MeSH terms

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