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At the 2022 Pediatric Academic Societies meeting, Carol Duh-Leong, MD, MPP led a discussion on the prenatal risk factors for high birthweight.
There are a great many maternal risk factors for giving birth to a high-weight infant. The quality of caloric intake of the mother, pre-pregnancy obesity, gestational diabetes, fast food access, offerings of the neighborhoods markets are but a few. Unfortunately, easy food access, high quality food, and food security are in short supply in many underserved communities around the United States, particularly in inner cities.
“Healthy food access risk factors likely will influence the odds of an infant’s high birthweight,” began Carol Duh-Leong, MD, MPP, an assistant professor of pediatrics at the NYU Grossman School of Medicine in New York City. Duh-Leong’s study focused on a sample of families with both economic disadvantage and racial diversity. The mean age of mothers was 30 years old; roughly half the respondents had a household income of between $20-$49,999. Nearly half (45.3%) were Latinx; About a third of the participants (33.9%) were Black, multirace/other, or Asian/Pacific Islander/American Indian; and 48.6% were born outside of the United States.
In the study, data was collected on 900 infants from birth to 2 years in 6 cities: Palo Alto, California; Nashville, Tennessee; Miami, Florida; Durham, North Carolina; Chapel Hill, North Carolina; and New York City, New York. The investigators defined a high birthweight as either being in the 90th percentile for gestational age or greater than or equal to 4000 grams (8.81849 pounds).
Mothers were asked about whether they agreed or not with a series of statements, which were:
-- it is easy to purchase low-fat products in my neighborhood
-- it is easy to purchase fresh fruits and vegetables
--there is a large selection of fresh fruits and vegetables available
--there is a large selection of low-fat products available
--the low-fat products are of high quality
The investigators determine that a response of “disagree” with at least 2 statements resulted in an unhealthy neighborhood food environment. Additionally, statements on food insecurity were also presented, extrapolated from the USDA Food Security Survey Module (we couldn’t afford to eat balanced meals; the food we bought just didn’t last; we didn’t have money to get more, etc.). Food insecurity was defined as an affirmative response from at least 2 of the statements.
Duh-Leong concluded that having even one risk factor increases the odds of high birthweight by 50% , while having 2 doubles the odds of high birthweight.
The study not only strengthens the rationale for addressing social determinants of health in giving birth to high-weight infants, but, as 1 audience member noted, perhaps cultural lifestyles should also be looked at in future studies. For example, even in a neighborhood where there was access to fresh fruits, vegetables and quality low-fat foods, parents might not choose those foods anyway, as the native food culture might have focused on high-fat meals and little to few fresh fruits and vegetables.
Duh-Leong C, Perrin EM, Mendelsohn A, et al. High birthweight: additive effects of health food access risk factors. PAS 2022. April 24, 2021. Denver, Colorado.