To our knowledge, no previous studies have examined the association between poor geographic accessibility to care and the possible harms of travel burdens for pregnant women. Future research that replicates these findings can assist in developing recommendations for pregnant women and health-care accessibility.

The objective of this study was to examine the association of life events stressors with risk of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) by using the multilevel sample from the 2007 Los Angeles Mommy and Baby (LAMB) survey. Four multilevel logistic regression models were applied while accounting for the multilevel design of the LAMB study. The following demographic variables were used as covariates: maternal age, race/ethnicity, maternal educational attainment, household income level in the previous year, physical exercise, and prepregnancy body weight status. The scale for total number of stressors was positively associated with GDM in Model 1, but the association did not reach the significance threshold of 0.05. In Model 2 where four specific domains of stressors (financial, traumatic, spousal, and emotional stressors) were used as the key exposure variables, the number of financial stressors during pregnancy was significantly associated with a higher risk of GDM. The scale for total number of stressors was associated with HDP in Model 3. Experience of financial stressors during pregnancy was significantly associated with a higher risk of HDP in Model 4. In conclusion, exposure to higher number of financial stressors was associated with an elevated risk of GDM and HDP.

INTRODUCTION: In Los Angeles County, 46% of postpartum women are overweight or obese. Unhealthy preconception weight increases the likelihood of retaining weight postpartum, but little is known about weight management interventions immediately postpartum. Choose Health LA Moms aims to provide education, resources, and support for postpartum weight management. This study highlights areas of focus needed in development of the program. METHODS: The 2012 Los Angeles Mommy and Baby Survey assessed 6,843 women before, during, and shortly after their most recent pregnancy. Data collected included demographics, geographic region, prepregnancy body mass index, breastfeeding status, and exercise during pregnancy. RESULTS:In Los Angeles County, 45.7% of women were overweight or obese preconception, 91.2% breastfed, and 79.1% exercised during pregnancy. Of eight total regions, region 6 and region 1 had the highest rates of being overweight or obese preconception (58.4% and 55.4%, respectively), the lowest rates of breastfeeding (84.4% and 88.2%), and among the lowest rates of exercising during pregnancy (75.5% and 73.2%). Latina and African American mothers had the highest overall rates of preconception obesity (57.4% and 56.8%, respectively) and the lowest rates of breastfeeding (89.3% and 84.2%). African American women had the lowest rate of exercising during pregnancy (72.1%). CONCLUSION: There is an inverse correlation between maternal obesity and breastfeeding as well as between maternal obesity and exercising during pregnancy. Postpartum obese women may require a targeted program that uses evidence-based interventions for weight loss such as breastfeeding and walking.