Discrimination and excessive weight gain during pregnancy among Black and Latina young women

Abstract

Rationale Excessive weight gain during pregnancy is a major determinant of later life obesity among both Black and Latina women and their offspring. However, psychosocial determinants of this risk, including everyday discrimination, and potential moderators of such effects remain unexplored. Objective We examined the influence of discrimination, a culturally relevant stressor, on odds of gaining weight beyond Institute of Medicine recommendations during pregnancy. Whether the effect was moderated by race/ethnicity, age, or depressive symptoms was also examined. Method Participants were 413 Black and Latina pregnant young women, ages 14-21 years. Experience with discrimination and all moderators were assessed in the second trimester. Last weight recorded in the third trimester was abstracted from medical records and used to determine excessive weight gain. Results Ever experiencing discrimination was associated with a 71% increase in the odds of excessive weight gain. The effect of discrimination was primarily present among women who attributed this treatment to membership in a historically oppressed group (e.g., ethnic minority, female) or to membership in other stigmatized groups (e.g., overweight). The effect of ever experiencing discrimination was not moderated by race/ethnicity or age but was moderated by depressive symptoms. Supporting the perspective of the environmental affordances model, discrimination strongly predicted excessive weight gain when women were low in depressive symptoms but had no effect when women were high in depressive symptoms. The moderating role of depressive symptoms was equivalent for Black and Latina women. Conclusion Results highlight the role of discrimination in perpetuating weight-related health disparities and suggest opportunities for improving health outcomes among young pregnant women.

Weight gain during pregnancy and the black-white disparity in preterm birth

“…35-36 Moreover, the built and social environments in which women live and work are likely contributors to their ability to gain a healthy amount of weight in pregnancy. 6,37,38 Our study findings highlight the need for continued research to determine how moderate weight gain during pregnancy can best be promoted at individual, community, and policy levels. Although our results are not from an intervention, they suggest that women achieving moderate weight gain could help meet the Healthy People 2020 goal of reducing preterm birth in the U.S. by 10%, as well as reduce the gap in early preterm birth rates between NH black and NH white women.…”

Perceived Racial/Ethnic Discrimination and Mental Health: a Review and Future Directions for Social Epidemiology

“…However, the studies we examined employed this scale in various ways. Some utilized a continuous score based on the sum of all nine responses [9–13], others dichotomized the variable into never and ever discrimination [14], and others averaged the scores of all the items [15–18]. Further, some studies asked participants to specify what they felt was the primary reason for the unfair treatment [11,13,14,18–20], while others did not appear to ask for such specification and examined perceived discrimination in general [9,10,12].…”

Postpartum Depressive Symptoms: Gestational Weight Gain as a Risk Factor for Adolescents Who Are Overweight or Obese

“…Weight was recorded at each prenatal visit, and abstracted systematically from the medical records. Weight gain was calculated by subtracting pre-pregnancy weight from the final third trimester weight prior to birth Following previous research, 27,28 weight gain was categorized as excessive if it exceeded the maximum recommended weight gain based on clinical guidelines, accounting for pre-pregnancy BMI category and gestational age at final weight assessment. Gestational age was determined by ultrasound, also abstracted from the medical records.…”