Physical activity and hypertensive disorders of pregnancy among Hispanic women.

PURPOSE: Prior studies of the association between physical activity and risk of hypertensive disorders of pregnancy have been conflicting, failed to assess total physical activity, and included few Hispanic women, the largest minority group in the United States with the highest birth rates. METHODS: We examined this association among 1043 participants in the Latina Gestational Diabetes Mellitus Study, a prospective cohort of predominantly Puerto Rican prenatal care patients conducted from 2000 to 2004 in western Massachusetts. Physical activity before and in early pregnancy was assessed by bilingual interviewers using a modified version of the Kaiser Physical Activity Survey. RESULTS: Fifty women (4.8%) were diagnosed with hypertensive disorders of pregnancy and 30 (2.9%) with preeclampsia. In multivariable analyses, there was a statistically significant trend of decreasing risk of hypertensive disorders with increasing sports/exercise in early pregnancy (P(trend) = 0.04). High levels of early pregnancy active living activity (odds ratio (OR) = 0.4, 95% confidence interval (CI) = 0.1-1.1, P(trend) = 0.07) and household/care giving activity (OR = 0.4, 95% CI = 0.1-1.3, P(trend) = 0.07) were associated with a 60% reduction in risk of hypertensive disorders relative to low levels; however, these associations were of marginal statistical significance. High levels of total physical activity (OR = 0.3, 95% CI = 0.1-1.0, P(trend) = 0.06) in early pregnancy were associated with a 70% reduction in the risk of hypertensive disorders relative to low levels; however, this association was also of marginal statistical significance. Prepregnancy physical activity was not associated with hypertensive disorders. CONCLUSIONS: These results in a Hispanic population, although based on small numbers of cases, corroborate previous studies suggesting that recreational activity in early pregnancy reduces the risk of hypertensive disorders of pregnancy.

Prepregnancy body mass index, gestational weight gain, and risk of hypertensive pregnancy among Latina women.

OBJECTIVE: Prepregnancy body mass index (BMI) and gestational weight gain have been associated with hypertensive disorders of pregnancy, but previous studies have included few Latinas, a group at increased risk. STUDY DESIGN: We examined these associations in the Latina Gestational Diabetes Mellitus Study, a prospective cohort of 1231 women conducted from 2000 to 2004. RESULTS: In multivariable analysis, obese women (BMI > 29.0 kg/m(2)) had 2.5 times the risk of hypertensive pregnancy (95% confidence interval [CI], 1.3-4.8) and 2.7 times the risk of preeclampsia (95% CI, 1.2-5.8), compared with women whose BMI was 19.8 to 26.0 kg/m(2). Women with excessive gestational weight gain had a 3-fold increased risk of a hypertensive disorder of pregnancy (95% CI, 1.1-7.2) and a 4-fold risk of preeclampsia (95% CI, 1.2-14.5), compared with women achieving weight gain guidelines. CONCLUSION: These findings suggest prepregnancy obesity and excessive weight gain are associated with hypertension in pregnancy in a Latina population and could be potentially modifiable risk factors.

Smoking and risk of preterm birth among predominantly Puerto Rican women.

PURPOSE: Studies of smoking during pregnancy and preterm birth among Hispanic women are sparse. Our goal was to evaluate the effect of cigarette smoking during pre-pregnancy, early pregnancy, and mid pregnancy on preterm birth among Hispanic women, the fastest growing ethnic group in the United States. METHODS: We evaluated data from a prospective cohort study of 1,041 Hispanic (predominantly Puerto Rican) women recruited between 2000 and 2004 in Springfield, Massachusetts. At recruitment (mean = 15 weeks), women reported their smoking since pregnancy awareness (early pregnancy) and in the year prior to pregnancy (pre-pregnancy). Mid pregnancy smoking was collected at a second interview (mean = 28 weeks). RESULTS: Smoking in pre-pregnancy was not associated with preterm birth. After adjustment for age, parity, education, and illicit drug use, women who smoked in early pregnancy had 1.6 times the risk of preterm birth (95% confidence interval [CI], 1.0-2.7) compared with nonsmokers. Women who smoked in mid pregnancy had 2.1 times the risk of preterm birth (95% CI, 1.0-4.2) compared with nonsmokers with a trend of increased risk of preterm birth with increasing levels of smoking (p trend, 0.03). CONCLUSIONS: Smoking in early or mid pregnancy increased the risk of spontaneous preterm birth in a Hispanic population.