Effects of Immigration Status and Maternal Health Behaviors on Gestational Weight Gain and Adherence to Institute of Medicine Gestational Weight Gain Recommendations

Gestational weight gain (GWG) is an important consideration during pregnancy as excess weight gains could lead to adverse health conditions in both mother and the child. Immigration status is a potential risk factor of excess GWG. It is important to understand the relationship between immigration status and GWG to design better interventions to control excess GWG. Therefore, the objectives of the current study were 1) to understand the differences between the first and second generation immigrants and non-immigrants with respect to the socio-demographic characteristics and maternal behaviors, 2) to understand whether immigration status is associated with the total GWG and the risk of excess GWG, 3) to determine the socio-demographic and maternal behavior profile of women exceeding the GWG recommendations. The study was conducted as a secondary data analysis using the National Longitudinal Survey of Youth 1979. The study sample included 2823 women (184 first generation, 207 second generation and 2432 non-immigrants) with term, singleton pregnancies reported after 1986. Socio-demographic data, maternal health behaviors, pre-pregnancy weight, GWG and immigration data were extracted from the survey reporting the pregnancy. ANOVA or Chi-square test was performed to determine socio-demographic and maternal behavior differences among the immigration groups. ANCOVA was used to determine differences in total GWG and logistic regression was used to assess the risk of excess GWG among the groups. Finally the characteristic profile of women exceeding GWG recommendations was identified using classification tree analysis. Finding from this study shows that immigration groups in the current study were different on their racial/ethnic composition, employment status, and marital status and education levels. The groups also were different in their smoking and alcohol consumption prior to and during pregnancy. However, after controlling for the covariates there were no differences in the total GWG among the three immigration groups. Also, there was no difference in the risk of exceeding GWG recommendation between the three immigration groups. According to the CRT analysis, among the first generation immigrants, pre-pregnancy overweight/obese and VISA/residency status indicated risk of excess GWG. Among second generation immigrants those who are overweight and obese prior to pregnancy were most likely to have excess GWG. Among non-immigrants, pre-pregnant overweight/obese, first child, and unplanned pregnancy indicated risk of excess GWG. Also, attempts to reduce caloric intake among non-Hispanic white women further increased the risk of excess GWG, whereas for all other racial/ethnic groups no attempts to reduce caloric intake increased the risk.