Racial/Ethnic Disparities in Inadequate Gestational Weight Gain Differ by Pre-pregnancy Weight

OBJECTIVES: Pre-pregnancy body mass index (BMI) varies by race/ethnicity and modifies the association between gestational weight gain (GWG) and adverse pregnancy outcomes, which disproportionately affect racial/ethnic minorities. Yet studies investigating whether racial/ethnic disparities in GWG vary by pre-pregnancy BMI are inconsistent, and none studied nationally representative populations. METHODS: Using categorical measures of GWG adequacy based on Institute of Medicine recommendations, we investigated whether associations between race/ethnicity and GWG adequacy were modified by pre-pregnancy BMI [underweight (<18.5kg/m(2)), normal weight (18.5-24.9 kg/m(2)), overweight (25.0-29.9 kg/m(2)), or obese (≥30.0 kg/m(2)) ] among all births to Black, Hispanic, and White mothers in the 1979 USA National Longitudinal Survey of Youth cohort (n=6849 pregnancies; range=1-10). We used generalized estimating equations, adjusted for marital status, parity, smoking during pregnancy, gestational age, and multiple measures of socioeconomic position. RESULTS: Effect measure modification between race/ethnicity and pre-pregnancy BMI was significant for inadequate GWG (Wald test p-value=0.08). Normal weight Black (Risk Ratio (RR)=1.34, 95% confidence interval (CI): 1.18, 1.52) and Hispanic women (RR=1.33, 95%CI: 1.15, 1.54) and underweight Black women (RR=1.38; 95% CI: 1.07, 1.79) experienced an increased risk of inadequate GWG compared to Whites. Differences in risk of inadequate GWG between minority women, compared to White women, were not significant among overweight and obese women. Effect measure modification between race/ethnicity and pre-pregnancy BMI was not significant for excessive GWG. CONCLUSIONS: The magnitude of racial/ethnic disparities in inadequate GWG appears to vary by pre-pregnancy weight class, which should be considered when designing interventions to close racial/ethnic gaps in healthy GWG

Couple pregnancy intentions and induced abortions in the United States

Objectives: Approximately half of US pregnancies are unintended and 43% of these end in induced abortions. Male partners and their involvement in reproductive decisions is not well understood. We examined the association between couple pregnancy intentions and induced abortion in US women. Materials and Methods: Data came from the National Survey of Family Growth (2006-2010). Primiparous women who lived with one husband or partner before conception of their first pregnancy were included in the analysis (N=4263). Multiple logistic regression was used to assess the relationship between couple pregnancy intentions and induced abortion of first pregnancy. Results: Approximately 17.1% of women reported discordant intentions and 32.3% reported that pregnancy was unintended by both parents. Among these couples, the women were more likely to be unmarried, minorities, of lower income and education, and 19 years of age or younger at conception than were couples in which both parents intended pregnancy. Compared to couples with a mutually intended pregnancy, those with discordant pregnancy intentions were significantly more likely to have induced abortion, even in women who desired pregnancy. Conclusion: Partners had a vital role in decisions to have an induced abortion. Health providers should consider the interpersonal decision-making process in couples to best prevent induced abortions due to unintended pregnancy. Providers should also be aware of the role of violence on reproductive decisions in couples with discordant pregnancy intentions. Women in healthy relationships can benefit from having frequent conversations about pregnancy with their partners

What is the role of culture, diversity, and community engagement in transdisciplinary translational science?

Concepts of culture and diversity are necessary considerations in the scientific application of theory generation and developmental processes of preventive interventions; yet, culture and/or diversity are often overlooked until later stages (e.g., adaptation [T3] and dissemination [T4]) of the translational science process. Here, we present a conceptual framework focused on the seamless incorporation of culture and diversity throughout the various stages of the translational science process (T1–T5). Informed by a community-engaged research approach, this framework guides integration of cultural and diversity considerations at each phase with emphasis on the importance and value of “citizen scientists” being research partners to promote ecological validity. The integrated partnership covers the first phase of intervention development through final phases that ultimately facilitate more global, universal translation of changes in attitudes, norms, and systems. Our comprehensive model for incorporating culture and diversity into translational research provides a basis for further discussion and translational science development