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1.
Matern Child Health J ; 10(1): 55-62, 2006 Jan.
Article in English | MEDLINE | ID: mdl-16496222

ABSTRACT

OBJECTIVES: To identify the biological, psychosocial, and behavioral characteristics that are associated with inadequate and/or excessive weight gain in pregnancy. METHODS: Univariate, bivariate, and multiple logistic regression analyses were conducted using data from Colorado's 2000-2002 Pregnancy Risk Assessment Monitoring System (PRAMS). Independent variables included biological risk factors (prepregnancy BMI, parity, preterm labor, maternal morbidity), psychosocial risk factors (pregnancy intention, WIC and Medicaid enrollment, area of residence, age, race/ethnicity, education, and stressors), and behavioral risk factors (smoking and drinking alcohol in the last trimester of pregnancy). RESULTS: In the bivariate analysis, all the biological risk factors were significantly associated with the pregnancy weight gain distribution, as were several of the psychosocial risk factors (WIC and Medicaid enrollment, area of residence, race/ethnicity, and maternal education). Smoking and alcohol use were not significant. After controlling for other variables through logistic regression, the only characteristics associated with inadequate weight gain were parity, underweight or obesity, preterm labor, nausea, residence in a rural area, low levels of education, and smoking. The characteristics associated with excessive weight gain were overweight or obesity, high blood pressure, and having 12 years of education. CONCLUSION: Having a pre-pregnancy BMI above 29 greatly increases the risk for both inadequate and excessive weight gain. Unfortunately, obesity, like the other major risk factors identified here (maternal education and parity) are not modifiable after a given pregnancy begins. To address these problems, a sustained approach to women's health, education, and well-being across the lifespan will be required, rather than a reliance upon targeted interventions during pregnancy.


Subject(s)
Obesity/epidemiology , Overweight/physiology , Pregnancy Complications/epidemiology , Risk Assessment , Adult , Body Mass Index , Colorado/epidemiology , Educational Status , Female , Humans , Hypertension , Medicaid/statistics & numerical data , Morning Sickness , Obesity/complications , Obesity/psychology , Obstetric Labor, Premature , Parity , Pregnancy , Pregnancy Complications/psychology , Residence Characteristics/classification , Risk Factors , Risk-Taking , Rural Population , Smoking/epidemiology , Thinness/complications , Thinness/epidemiology
2.
Matern Child Health J ; 6(4): 247-53, 2002 Dec.
Article in English | MEDLINE | ID: mdl-12512766

ABSTRACT

OBJECTIVE: This study identified correlates of self-reports of being very depressed in the months after delivery in a population-based sample of women. METHODS: We analyzed data on 14,609 recent mothers from the Centers for Disease Control and Prevention's (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS). The sample included mothers who delivered a live birth in Colorado, New York State, and North Carolina from 1996 (New York only) to 1999. We assessed risk factors for self-reports of being very depressed in the months after delivery using logistic regression. RESULTS: Overall, 5.9% (95% CI = 5.3, 6.4) of new mothers reported being very depressed in the months after delivery. Women who reported that their pregnancy was a "very hard time" or "one of the worst times of my life" had the highest prevalence of reporting being very depressed in the months after delivery (24.9%, 95% CI = 21.3, 28.5) and, when all risk factors were adjusted for simultaneously, were 4.6 times (95% CI = 3.1, 6.3) more likely to report being very depressed in the months after delivery than other women. Other significant risk factors for self-reports of being very depressed in the months after delivery included experiencing partner-associated stress (OR = 1.9, 95% CI = 1.5, 2.5), physical abuse during pregnancy (OR = 1.6, 95% CI = 1.1, 2.4), and not breast-feeding (OR = 1.4, 95% CI = 1.1, 1.8). CONCLUSIONS: The highest prevalence for self-reports of being very depressed in the months after delivery was in women who reported that their pregnancy was a "very hard time" or "one of the worst times of my life." Clinicians need to be aware of the needs of some women for mental health services both during and after pregnancy.


Subject(s)
Depression, Postpartum/epidemiology , Maternal Welfare , Self-Assessment , Adult , Behavioral Risk Factor Surveillance System , Colorado/epidemiology , Female , Humans , Logistic Models , New York/epidemiology , North Carolina/epidemiology , Population Surveillance , Pregnancy , Pregnancy Complications/psychology , Prevalence , Risk Factors , Socioeconomic Factors
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