The educational gradient of obesity increases among Swedish pregnant women: a register-based study

Abstract

BackgroundOverweight or obesity is detrimental during pregnancy. We studied time trends in the educational gradient of overweight and obesity among pregnant women. Differences in overweight and obesity by area of residence and country of birth were also examined.MethodsThe study was based on the Swedish Medical Birth Register between 1992 and 2010 and included 1,569,173 singleton pregnancies. Weight and height were registered during the first visit at the antenatal-care clinic. Data on education, country of birth, and area of residence were derived from registers with national coverage.ResultsIn 2008–2010, 32% of Swedish nulliparous pregnant women were overweight or obese. The relative risk of obesity among lower educated women compared to women with higher education increased from 1.91 (95% confidence interval: 1.85-1.97) in 1992–1995 to 2.09 (95% confidence interval: 2.05-2.14) in 2008–2010. There was an inverse linear relationship between risks of overweight or obesity, and population density and type of residence municipality. An excessive gestational weight gain according to the American Institute of Medicine was observed among 57-63% of the overweight or obese women, but there were small differences by education. Pregnant women born in Africa, Middle East or Latin America had higher risks of being overweight or obese compared to women born in Sweden.ConclusionsThe prevalence of obesity as well as the social inequalities in obesity during pregnancy increased in Sweden between 1992 and 2010. Further understanding of social inequalities and geographical differentials in health behaviours of pregnant women is needed when planning public health interventions.

Preconception management of women with obesity: A systematic review

“…It is predicted that over the next decade, the greatest increase in the prevalence of obesity will occur in women of reproductive age . Studies across numerous developed nations demonstrate that obesity disproportionately affects women belonging to lower socioeconomic groups, those with lower levels of education and those of certain ethnic groups …”

Social inequality in pre-pregnancy BMI and gestational weight gain in the first and second pregnancy among women in Sweden

“…Women with a low socioeconomic position (SEP) are at higher risk of pre-pregnancy overweight/obesity,1 25 and this social differential seems to have widened over time among obese individuals in Sweden 26. Lower SEP (measured by education or occupation) is also inversely associated with weight retention11 20 and long-term BMI in women,9 27 28 though less is known about the role of SEP for GWG.…”

Determinants of the self-efficacy of physical activity for maintaining weight during pregnancy: The application of the health belief model

“…[ 1 2 ] Disregard for this important period is likely to result in complications such as obesity and overweight in the mother. It is accompanied by short-term and long-term complications in the mother and the infant, including blood-pressure disorders,[ 3 4 ] gestational diabetes, preeclampsia, long-term maternal diabetes,[ 5 6 7 ] eclampsia, cesarean section,[ 8 ] the increased risk of fetal macrosomia, childhood obesity,[ 9 10 ] and the increased risk of autism. [ 11 ] According to an estimate from the Centers for Disease Control and Prevention, around 48% of American women exceed the Institute of Medicine guidelines for standard weight gain during pregnancy.…”