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