Maya Tabet1, Erik Nelson2, Mario Schootman3, Lung-Chang Chien4, Jen Jen Chang3. 1. Department of Epidemiology, Saint Louis University College for Public Health and Social Justice, St. Louis, MO. Electronic address: mtabet@slu.edu. 2. Department of Epidemiology and Biostatistics, Indiana University School of Public Health - Bloomington, Bloomington, IN. 3. Department of Epidemiology, Saint Louis University College for Public Health and Social Justice, St. Louis, MO. 4. Department of Environmental and Occupational Health, University of Nevada, Las Vegas, School of Community Health Sciences, Las Vegas.
Abstract
PURPOSE: We examined the extent of geographic variability in gestational weight gain (GWG), identified areas where women have suboptimal GWG, and evaluated whether individual- and area-level factors account for such variability. METHODS: We conducted a population-based cohort study including 1,385,574 women delivering term, singleton, and live births in Florida. We used a Bayesian, structured additive regression with a spatial function to analyze data from Florida's birth certificates (2005-2012) and ZIP code tabulation areas (ZCTAs; 2010 Census). RESULTS: The prevalence of insufficient (7.7%-42.9%) and excessive (17.1%-82.4%) GWG varied widely within Florida. Geographic variability was not explained by risk factors under study. Clusters in Orlando, Tampa, and Miami exhibited increased likelihood of insufficient GWG, whereas clusters in the Northwest of Florida exhibited increased likelihood of excessive GWG. CONCLUSIONS: We identified areas in Florida with high likelihood of suboptimal GWG that policy-makers should prioritize in the implementation of programs for optimizing GWG.
PURPOSE: We examined the extent of geographic variability in gestational weight gain (GWG), identified areas where women have suboptimal GWG, and evaluated whether individual- and area-level factors account for such variability. METHODS: We conducted a population-based cohort study including 1,385,574 women delivering term, singleton, and live births in Florida. We used a Bayesian, structured additive regression with a spatial function to analyze data from Florida's birth certificates (2005-2012) and ZIP code tabulation areas (ZCTAs; 2010 Census). RESULTS: The prevalence of insufficient (7.7%-42.9%) and excessive (17.1%-82.4%) GWG varied widely within Florida. Geographic variability was not explained by risk factors under study. Clusters in Orlando, Tampa, and Miami exhibited increased likelihood of insufficient GWG, whereas clusters in the Northwest of Florida exhibited increased likelihood of excessive GWG. CONCLUSIONS: We identified areas in Florida with high likelihood of suboptimal GWG that policy-makers should prioritize in the implementation of programs for optimizing GWG.