Limited or no weight gain in obese pregnant women has favorable pregnancy outcomes.

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Objectives To examine correlates of lifetime mental health services (MHS) use among pregnant women reporting prenatal depressive symptoms by race/ethnicity. Methods This cross-sectional population-based study included 81,910 pregnant women with prenatal depressive symptoms using data from the Florida Healthy Start prenatal screening program (2008-2012). Multivariable logistic regression was conducted to ascertain adjusted odds ratios and corresponding 95 % confidence intervals for racial/ethnic differences in the correlates of lifetime MHS use. Results Findings of this study revealed racial/ethnic differences in MHS use among women with prenatal depressive symptoms, the highest rates being among non-Hispanic Whites and the lowest rates among Mexicans and other Hispanics. Most need for care factors, including illness, tobacco use, and physical or emotional abuse, consistently predicted MHS use across racial/ethnic groups after adjusting for covariates. Adjusted associations between predisposing and enabling/restricting factors and MHS use were different for different racial/ethnic groups. Conclusions Racial/ethnic differences in MHS use were found, with pregnant Hispanic women reporting prenatal depressive symptoms being the least likely to use MHS. Our study findings have significant public health implications for targeted intervention for pregnant women with prenatal depressive symptoms.

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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.