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1.
Obes Surg ; 33(8): 2276-2281, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37329409

RESUMO

INTRODUCTION: As the utilization of metabolic and bariatric surgery (MBS) continues to rise, it is important to address the nutritional needs of women who had MBS who become pregnant. Not meeting those nutritional needs could lead to complications associated with malnutrition. To better understand the relationship between MBS, pregnancy, and malnutrition, this study sought to determine whether differences exist in the presence of malnutrition during pregnancy in women with a history of MBS compared to women without a history of MBS. METHODS: This cross-sectional study used the National Inpatient Sample (NIS) from 2012 to 2017, which samples 20% of hospital discharges in the USA. Multivariate logistic regression models were fitted, and odds rations and 95% confidence intervals were calculated with obesity and MBS as the independent variables and malnutrition during pregnancy as the dependent variable. Covariates included in the multivariate model were age, primary payer, hypertension, hyperlipidemia, and depression. RESULTS: Compared to women who did not have MBS, women who had MBS had higher odds of malnutrition during pregnancy (aOR = 8.33, 95% CI 7.30-9.50), this result was moderated by racial category (aORBlack = 6.35, 95% CI 4.97-8.13; aORwhite = 8.25, 95% CI 7.00-9.73; aORLatina = 10.93, 95% CI 8.38-14.25). Women with obesity also had higher odds of malnutrition during pregnancy. CONCLUSIONS: The increased odds of malnutrition among women with MBS suggests that it is important to consider tailoring nutrition recommendations to address the different nutritional needs of pregnant women who had MBS and may be at risk for malnutrition.


Assuntos
Cirurgia Bariátrica , Desnutrição , Obesidade Mórbida , Complicações na Gravidez , Gravidez , Feminino , Humanos , Estudos Transversais , Obesidade Mórbida/cirurgia , Complicações na Gravidez/cirurgia , Obesidade/complicações , Obesidade/cirurgia , Cirurgia Bariátrica/efeitos adversos , Desnutrição/epidemiologia , Desnutrição/etiologia
2.
Surg Obes Relat Dis ; 19(10): 1142-1147, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37150625

RESUMO

BACKGROUND: Stroke during pregnancy is rare, occurring in 30 of 100,000 pregnancies and accounting for 7% of maternal deaths in the United States from 2016 to 2018. Metabolic and bariatric surgery (MBS) has been shown to reduce symptoms of chronic conditions that are risk factors for stroke, including hypertension, hypercholesterolemia, and diabetes in women. However, little is known about the impact of MBS on stroke risk during pregnancy. OBJECTIVES: To examine stroke and stroke risk factors including preeclampsia, eclampsia, gestational hypertension, and embolism/thrombosis in women of reproductive age who have had MBS. SETTING: We used the National Inpatient Sample, a publicly available data set from the Healthcare Cost and Utilization Project that samples 20% of hospital discharges in the United States. METHODS: This cross-sectional study included women between the ages of 20 and 44 years who had a maternal admission code. Weighted logistic regression was conducted to assess the odds of stroke and stroke risk factors in women with a history of MBS compared with other women of reproductive age. RESULTS: Women with a history of MBS have 12% lower adjusted odds of developing preeclampsia/eclampsia and 10% lower adjusted odds of gestational hypertension than women who did not undergo MBS. When stratified by race, the difference was significant in White women (preeclampsia/eclampsia: adjusted odds ratio [aOR] = .89; 95% confidence interval [CI], .81-.98; gestational hypertension: aOR = .91; 95% CI, .83-1.00). Latinas with MBS had significantly lower odds of preeclampsia/eclampsia (aOR = .75; 95% CI, .64-.90). CONCLUSIONS: MBS helps women lose weight and decrease the incidence of some pregnancy-related risk factors for stroke. However, there is a notable racial health disparity.


Assuntos
Cirurgia Bariátrica , Eclampsia , Hipertensão Induzida pela Gravidez , Pré-Eclâmpsia , Acidente Vascular Cerebral , Gravidez , Feminino , Estados Unidos/epidemiologia , Humanos , Adulto Jovem , Adulto , Hipertensão Induzida pela Gravidez/epidemiologia , Hipertensão Induzida pela Gravidez/etiologia , Pré-Eclâmpsia/epidemiologia , Estudos Transversais , Fatores de Risco , Cirurgia Bariátrica/efeitos adversos , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia
3.
World J Clin Cases ; 10(7): 2147-2158, 2022 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-35321178

RESUMO

BACKGROUND: Diabetes rates among pregnant women in the United States have been increasing and are associated with adverse pregnancy outcomes. AIM: To investigate differences in birth outcomes (preterm birth, macrosomia, and neonatal death) by diabetes status. METHODS: Cross-sectional design, using linked Missouri birth and death certificates (singleton births only), 2010 to 2012 (n = 204057). Exposure was diabetes (non-diabetic, pre-pregnancy diabetes-insulin dependent (PD-I), pre-pregnancy diabetes-non-insulin dependent (PD-NI), gestational diabetes- insulin dependent (GD-I), and gestational diabetes-non-insulin dependent (GD-NI)]. Outcomes included preterm birth, macrosomia, and infant mortality. Confounders included demographic characteristics, adequacy of prenatal care, body mass index, smoking, hypertension, and previous preterm birth. Bivariate and multivariate logistic regression assessed differences in outcomes by diabetes status. RESULTS: Women with PD-I, PD-NI, and GD-I remained at a significantly increased odds for preterm birth (aOR 2.87, aOR 1.77, and aOR 1.73, respectively) and having a very large baby [macrosomia] (aOR 3.01, aOR 2.12, and aOR 1.96, respectively); in reference to non-diabetic women. Women with GD-NI were at a significantly increased risk for macrosomia (aOR1.53), decreased risk for their baby to die before their first birthday (aOR 0.41) and no difference in risk for preterm birth in reference to non-diabetic women. CONCLUSION: Diabetes is associated with the poor birth outcomes. Clinical management of diabetes during pregnancy and healthy lifestyle behaviors before pregnancy can reduce the risk for diabetes and poor birth outcomes.

4.
Obes Surg ; 32(4): 991-997, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35041122

RESUMO

BACKGROUND: The objective of this study was to assess the effect of WLS on pregnancy and delivery complications in women who had WLS compared to women with obesity who did not undergo WLS. METHODS: We used the National Inpatient Sample data from 2012 to 2017, with a study population of women between the ages of 20 and 44 who had a maternal admission code in the NIS data (n = 663,795). Weighted logistic regression models were fitted and the models were stratified by race. Covariates included age, race, primary payer, previous cesarean delivery, physical health comorbidities, and depression. RESULTS: There were decreased odds of gestational diabetes in women of all races (aORall = 0.47, 95% CIall = 0.44-0.49). There were decreased odds for gestational hypertension in women of all races (aORall = 0.55, 95% CIall = 0.51-0.59). Compared to women who did not have WLS, there were lower odds of cesarean delivery among women with a history of WLS (aORall = 0.62, 95% CIall = 0.60-0.65), which was true for White women, Black women, and Latinas with a history of WLS (aORWhite = 0.57, 95% CIWhite = 0.53-0.60; aORBlack = 0.67, 95% CIBlack = 0.61-0.74; aORLatina = 0.71, 95% CILatina = 0.64-0.78). CONCLUSIONS: Overall, women with history of WLS had lower odds of most of the pregnancy outcomes (gestational diabetes, gestational hypertension, pre-eclampsia/eclampsia, and cesarean delivery) with results mediated by race.


Assuntos
Cirurgia Bariátrica , Diabetes Gestacional , Hipertensão Induzida pela Gravidez , Obesidade Mórbida , Pré-Eclâmpsia , Complicações na Gravidez , Adulto , Diabetes Gestacional/epidemiologia , Feminino , Humanos , Hipertensão Induzida pela Gravidez/epidemiologia , Masculino , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/cirurgia , Obesidade Mórbida/cirurgia , Pré-Eclâmpsia/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/cirurgia , Resultado da Gravidez/epidemiologia , Adulto Jovem
5.
Matern Child Health J ; 23(10): 1434-1441, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31302877

RESUMO

BACKGROUND: Women who smoke cigarettes while pregnant are at elevated risk of having low birth weight infants (LBW, < 2500 g) which increases risks of infant mortality and morbidity, including chronic conditions later in life. OBJECTIVE: Smoking cessation during pregnancy can reduce the risk of poor birth outcomes. However, the effect that timing of smoking cessation has on the reduction of poor birth outcomes in term pregnancies is unknown. STUDY DESIGN: This retrospective cohort study used birth certificate data from Missouri singleton, full-term, live births from 2010 to 2012 (N = 179,653) to examine the rates and timing of smoking cessation during pregnancy on birthweight. Smoking exposure was categorized as non-smoker, preconception cessation, first trimester cessation, second trimester cessation, and smoker. The outcome was low birth weight (LBW). Covariates included maternal race/ethnicity, age, education level, type of payment for the delivery, marital status, paternal acknowledgement, prenatal sexually transmitted infection (STI), comorbidities, and body mass index. Bivariate and multivariable analyses were used to assess relationships between smoking and LBW status. RESULTS: Preconception cessation did not have a statistically higher risk for LBW than mothers who never smoked (aOR 1.12; 95% CI 0.98, 1.28). First trimester cessation (aOR 1.26; 95% CI 1.05, 1.52), second trimester cessation (aOR 2.00; 95% CI 1.60, 2.67), and smoker (aOR 2.46; 95% CI 2.28, 2.67) had increasing odds for LBW relative to mothers who did not smoke. All covariates had significant relationships with the smoking exposure. CONCLUSION: Preconception cessation yielded LBW rates comparable to non-smokers. The risk for LBW increased as smoking continued throughout pregnancy among full term births, an important new finding in contrast with other studies.


Assuntos
Recém-Nascido de Baixo Peso/metabolismo , Comportamento de Redução do Risco , Abandono do Hábito de Fumar/estatística & dados numéricos , Fatores de Tempo , Adolescente , Adulto , Índice de Massa Corporal , Estudos de Coortes , Feminino , Humanos , Recém-Nascido de Baixo Peso/fisiologia , Modelos Logísticos , Missouri , Gravidez , Estudos Retrospectivos , Fatores de Risco
6.
Respiration ; 93(3): 189-197, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28092910

RESUMO

BACKGROUND: Little information exists on whether gender or asthma status modifies the effects of secondhand smoke (SHS) exposure on lung function. OBJECTIVE: To evaluate whether gender or asthma status modifies the association of SHS exposure with lung function. METHODS: A total of 6,740 children (average 11.6 years) were recruited from 24 districts of 7 cities in northeast China in 2012. SHS exposure included exposure to environmental and maternal smoking both in utero and during early childhood (postnatal). Lung function was measured using electronic spirometers. Two-step regressions were used to analyze the association between SHS and lung function. RESULTS: In utero and postnatal exposure to SHS was independently associated with decreased lung function in both genders; however, this association was greater among males. For example, when exposed to maternal smoking during pregnancy, the adjusted odds ratio (aOR) for decreased forced vital capacity (FVC) was 6.46 (95% confidence interval [CI]: 2.58-16.17) among males, while only 2.16 (95% CI: 0.96-4.88) among females. More positive associations between SHS exposure and decreased lung function were detected among nonasthmatic compared with asthmatic children. Nonasthmatics had significantly larger deficits from in utero exposure to maternal smoking, which concerned decreased lung FVC function (aOR = 2.58, 95% CI: 1.28-5.21) and decreased lung forced expiratory volume in 1 s (FEV1) function (aOR = 2.32, 95% CI: 1.01-5.33). A similar pattern was also observed for the associations between SHS exposure and continuous pulmonary function test measurements. CONCLUSIONS: SHS exposure was associated with decreased lung function. Males and nonasthmatics seem to be more susceptible than their respective counterparts.


Assuntos
Asma/fisiopatologia , Exposição Ambiental , Pulmão/fisiopatologia , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Poluição por Fumaça de Tabaco , Adolescente , Asma/epidemiologia , Criança , China/epidemiologia , Cidades , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Razão de Chances , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Análise de Regressão , Fatores Sexuais , Espirometria , Capacidade Vital
7.
Matern Child Health J ; 20(3): 623-9, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26537389

RESUMO

OBJECTIVES: This study examined risk and protective factors associated with very low birth weight (VLBW) for babies born to women receiving adequate or inadequate prenatal care. METHODS: Birth records from St. Louis City and County from 2000 to 2009 were used (n = 152,590). Data was categorized across risk factors and stratified by adequacy of prenatal care (PNC). Multivariate logistic regression and population attributable risk (PAR) was used to explore risk factors for VLBW infants. RESULTS: Women receiving inadequate prenatal care had a higher prevalence of delivering a VLBW infant than those receiving adequate PNC (4.11 vs. 1.44 %, p < .0001). The distribution of risk factors differed between adequate and inadequate PNC regarding Black race (36.4 vs. 79.0 %, p < .0001), age under 20 (13.0 vs. 33.6 %, p < .0001), <13 years of education (35.9 vs. 77.9 %, p < .0001), Medicaid status (35.7 vs. 74.9, p < .0001), primiparity (41.6 vs. 31.4 %, p < .0001), smoking (9.7 vs. 24.5 %, p < .0001), and diabetes (4.0 vs. 2.4 %, p < .0001), respectively. Black race, advanced maternal age, primiparity and gestational hypertension were significant predictors of VLBW, regardless of adequate or inadequate PNC. Among women with inadequate PNC, Medicaid was protective against (aOR 0.671, 95 % CI 0.563-0.803; PAR -32.6 %) and smoking a risk factor for (aOR 1.23, 95 % CI 1.01, 1.49; PAR 40.1 %) VLBW. When prematurity was added to the adjusted models, the largest PAR shifts to education (44.3 %) among women with inadequate PNC. CONCLUSIONS: Community actions around broader issues of racism and social determinants of health are needed to prevent VLBW in a large urban area.


Assuntos
Recém-Nascido de muito Baixo Peso , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Cuidado Pré-Natal/estatística & dados numéricos , Fatores de Proteção , Adulto , Estudos de Coortes , Escolaridade , Feminino , Humanos , Hipertensão Induzida pela Gravidez/epidemiologia , Recém-Nascido , Recém-Nascido Prematuro , Modelos Logísticos , Idade Materna , Medicaid , Missouri/epidemiologia , Análise Multivariada , Paridade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Gravidez , Prevalência , Fatores de Risco , Estados Unidos , População Urbana/estatística & dados numéricos , Adulto Jovem
8.
Biomed Res Int ; 2014: 515827, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25105127

RESUMO

OBJECTIVE: To identify social, behavioral, and physiological risk factors associated with small for gestational age (SGA) by gestational age category in St. Louis City and County. METHODS: A retrospective cohort study was conducted using birth certificate and fetal death records from 2000 to 2009 (n = 142,017). Adjusted associations of risk factors with SGA were explored using bivariate logistic regression. Four separate multivariable logistic regression analyses, stratified by gestational age, were conducted to estimate adjusted odds ratios. RESULTS: Preeclampsia and inadequate weight gain contributed significantly to increased odds for SGA across all gestational age categories. The point estimates ranged from a 3.41 increased odds among women with preeclampsia and 1.76 for women with inadequate weight gain at 24-28 weeks' gestational age to 2.19 and 2.11 for full-term infants, respectively. Among full-term infants, smoking (aOR = 2.08), chronic hypertension (aOR = 1.46), and inadequate prenatal care (aOR = 1.25) had the next most robust and significant impact on SGA. CONCLUSION: Preeclampsia and inadequate weight gain are significant risk factors for SGA, regardless of gestational age. Education on the importance of nutrition and adequate weight gain during pregnancy is vital. In this community, disparities in SGA and smoking rates are important considerations for interventions designed to improve birth outcomes.


Assuntos
Idade Gestacional , Recém-Nascido Pequeno para a Idade Gestacional , Pré-Eclâmpsia/epidemiologia , Fenômenos Fisiológicos da Nutrição Pré-Natal , Aumento de Peso , Feminino , Humanos , Recém-Nascido , Minnesota , Pré-Eclâmpsia/etiologia , Pré-Eclâmpsia/fisiopatologia , Gravidez , Fatores de Risco
9.
Biomed Res Int ; 2014: 547234, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25025058

RESUMO

OBJECTIVE: Very low birth weight (VLBW) is a significant issue in St. Louis, Missouri. Our study evaluated risk factors associated with VLBW in this predominantly urban community. METHODS: From 2000 to 2009, birth and fetal death certificates were evaluated (n = 160, 189), and mortality rates were calculated for perinatal periods of risk. The Kitagawa method was used to explore fetoinfant mortality rates (FIMR) in terms of birth weight distribution and birthweight specific mortality. Multivariable logistic regression was used to assess the magnitude of association of selected risk factors with VLBW. RESULTS: VLBW contributes to 50% of the excess FIMR in St. Louis City and County. The highest proportion of VLBW can be attributed to black maternal race (40.6%) in St. Louis City, inadequate prenatal care (19.8%), and gestational hypertension (12.0%) among black women. Medicaid was found to have a protective effect for VLBW among black women (population attributable risk (PAR) = -14.5). DISCUSSION: Interventions targeting the health of women before and during conception may be most successful at reducing the disparities in VLBW in this population. Interventions geared towards smoking cessation and improvements in Medicaid and prenatal care access for black mothers and St. Louis City residents can greatly reduce VLBW rates.


Assuntos
Morte Fetal , Hipertensão Induzida pela Gravidez/epidemiologia , Recém-Nascido de muito Baixo Peso , Adulto , Criança , Etnicidade , Feminino , Humanos , Recém-Nascido , Missouri/epidemiologia , Assistência Perinatal , Gravidez , Fatores de Risco , Fatores Socioeconômicos
10.
J Womens Health (Larchmt) ; 22(3): 203-9, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23428283

RESUMO

OBJECTIVES: This article assesses emerging trends in the 21st century, if any, in preconception health indicators among women of reproductive age. METHODS: This is a secondary analysis of cross-sectional data from the Behavioral Risk Factor Surveillance System (BRFSS), 2003-2010. Subjects were a sample of noninstitutionalized, 18-44-year-old, nonpregnant, women in the United States (n=547,177) grouped into two categories, 2003-2006 (n=275,630) and 2007-2010 (n=271,547). Overall crude and adjusted prevalence odds ratios were calculated for preconception indicators before 2006 and after 2006. RESULTS: Significant improvements were found for any and heavy alcohol use, smoking, social and emotional support, moderate/vigorous physical activity, and having had an influenza shot in the last year. In contrast, binge drinking, having a medical condition (i.e., diabetes, high blood pressure, asthma, or obesity), and self-reported health significantly worsened. No change was found for mental distress, HIV testing, and having a routine checkup. CONCLUSIONS: As the 21st century unfolds, emerging trends suggest that we need to focus on educating women, providers, and public health advocates about improved health before pregnancy, especially for women with chronic conditions and those who binge drink alcohol.


Assuntos
Sistema de Vigilância de Fator de Risco Comportamental , Indicadores Básicos de Saúde , Cuidado Pré-Concepcional/tendências , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Adulto Jovem
11.
J Immigr Minor Health ; 14(2): 216-22, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21161383

RESUMO

Disparities in health between immigrant and non-immigrant pregnant women in the United States is well documented, but few have documented disparities before pregnancy. Using the National Health and Nutrition Examination Survey (1999-2006), we examined the health of reproductive-aged women (8,095), sorted by immigrant and pregnancy pregnant US-born (P-US), pregnant foreign-born (P-FB), non-pregnant US-born (NP-US), and non-pregnant foreignborn (NP-FB). P-US women were 5.2 times more likely to report illicit drug use than P-FB women. NP-US women were 3.7 times more likely to report illicit drugs use, 45% less likely to have a normal BMI, 2.0 times more likely to binge drink, 7.6 times more likely to smoke, 1.6 times more likely to engage in moderate physical activity, and 1.7 times more likely to use birth control than NP-FB women. The lower prevalence of numerous destructive health behaviors among preconceptional immigrant women is an important finding.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Comportamentos Relacionados com a Saúde/etnologia , Disparidades nos Níveis de Saúde , Cuidado Pré-Concepcional/estatística & dados numéricos , Adolescente , Adulto , Criança , Feminino , Inquéritos Epidemiológicos , Humanos , Estilo de Vida/etnologia , Gravidez , Fatores Socioeconômicos , Estados Unidos , Adulto Jovem
12.
Womens Health Issues ; 19(5): 306-12, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19733800

RESUMO

CONTEXT: Little is known about the preconception health status of women that are at risk for an unintended pregnancy. OBJECTIVE: We hypothesized that women at high risk for an unintended pregnancy would engage in less healthy behaviors and would have fewer health care encounters than women at lower risk. DESIGN: Using the Behavioral Risk Factor Surveillance System (2002 and 2004 datasets), we examined health factors of 18- to 44-year-old, fertile women who were not intending a pregnancy, grouped into high-risk (n=16,113) or low-risk (n=39,426) groups. Women were designated as high risk for an unintended pregnancy based on their non-use of birth control, and women were designated as low-risk for an unintended pregnancy based on their use of birth control. RESULTS: Controlling for variables that mask or exacerbate relationships between risk factors and outcomes was an important component of this study. After controlling for the effects of demographic characteristics, we found that high-risk women remained 1.23 times more likely to be obese (confidence interval [CI], 1.12-1.34) and 1.2 times more likely to smoke (CI, 1.11-1.31), both significant findings. We also found high-risk women to be 27% less likely to exercise (CI, 0.67-0.79), 62% less likely to receive a Pap test (CI, 0.31-0.46), 19% less likely to have HIV testing (CI, 0.75-0.87), and 44% less likely to have received sexually transmitted diseases counseling (CI, 0.50-0.63) compared with low-risk women. Interestingly, high-risk women were 27% less likely to use any alcohol (CI, 0.67-0.79) and 11% less likely to binge drink (CI, 0.80-0.99) compared with women at low-risk for an unintended pregnancy. CONCLUSIONS: Nearly one third of women at risk for an unintended pregnancy are not using any contraceptive method (29%), and these high-risk women also have higher proportions of unhealthy behaviors and significantly lower clinical health encounters than women using any form of birth control (low-risk women).


Assuntos
Comportamentos Relacionados com a Saúde , Gravidez não Desejada , Adolescente , Adulto , Sistema de Vigilância de Fator de Risco Comportamental , Anticoncepção/estatística & dados numéricos , Feminino , Nível de Saúde , Humanos , Gravidez , Medição de Risco , Estados Unidos , Adulto Jovem
13.
Matern Child Health J ; 13(5): 604-13, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18780169

RESUMO

OBJECTIVE: The purpose of this study was to investigate the likelihood that women of different racial and ethnic groups would reduce their alcohol consumption during pregnancy. METHODS: Data came from 22 states participating in the Pregnancy Risk Assessment Monitoring System from 2001 to 2005. After stratifying the sample by preconception drinking level, logistic regressions were used to predict drinking reduction and cessation by the third trimester by race, controlling for age, education, marital status, Medicaid status, pregnancy intention, smoking status, and state. RESULTS: Overall, Black, Asian/Pacific Islander and Hispanic women were all significantly less likely than White women to reduce their heavy drinking after becoming pregnant. American Indian/Alaskan Native women who were moderate drinkers before conception were over 2 times more likely than White women to reduce drinking after becoming pregnant (OR 2.19, CI 0.71, 6.76), although this difference was non-significant (P = .17). Among those who binge drank in the months before pregnancy, compared to White women, Black (OR 0.26, CI 0.17-0.39), Hispanic (OR 0.19, CI 0.12-0.29), American Indian/Alaskan Native (OR 0.44 CI 0.20, 0.96), and Asian/Pacific Islander women (OR 0.11, CI 0.06-0.22) were all less likely to quit binge drinking while pregnant. CONCLUSION: Significant racial differences in pregnancy-related drinking reduction are evident, and may help explain racial disparities in FAS. Results suggest that more targeted efforts are needed to meet the national goals of preventing alcohol-exposed pregnancies.


Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Intoxicação Alcoólica/etnologia , Disparidades nos Níveis de Saúde , Complicações na Gravidez/etnologia , Comportamento de Redução do Risco , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/prevenção & controle , Intoxicação Alcoólica/complicações , Intoxicação Alcoólica/epidemiologia , Intoxicação Alcoólica/prevenção & controle , Feminino , Transtornos do Espectro Alcoólico Fetal/epidemiologia , Transtornos do Espectro Alcoólico Fetal/etnologia , Transtornos do Espectro Alcoólico Fetal/etiologia , Transtornos do Espectro Alcoólico Fetal/prevenção & controle , Humanos , Funções Verossimilhança , Modelos Logísticos , Gravidez , Complicações na Gravidez/induzido quimicamente , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/prevenção & controle , Gravidez não Planejada , Estudos Retrospectivos , Fumar , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
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