The Influence of Maternal Weight and Glucose Tolerance on Infant Birthweight in Latino Mother–Infant Pairs

Objectives. We assessed the influence of maternal anthropometric and metabolic variables, including glucose tolerance, on infant birthweight. Methods. In our prospective, population-based cohort study of 1041 Latino mother–infant pairs, we used standardized interviews, anthropometry, metabolic assays, and medical record reviews. We assessed relationships among maternal sociodemographic, prenatal care, anthropometric, and metabolic characteristics and birthweight with analysis of variance and bivariate and multivariate linear regression analyses. Results. Forty-two percent of women in this study entered pregnancy overweight or obese; at least 36% exceeded weight-gain recommendations. Twenty-seven percent of the women had at least some degree of glucose abnormality, including 6.8% who had gestational diabetes. Maternal multiparity, height, weight, weight gain, and 1-hour screening glucose levels were significant independent predictors of infant birthweight after adjustment for gestational age. Conclusion. Studies of birthweight should account for maternal glucose level. Given the increased risk of adverse maternal and infant outcomes associated with excessive maternal weight, weight gain, and glucose intolerance, and the high prevalence of these conditions and type 2 diabetes among Latinas, public health professionals have unique opportunities for prevention through prenatal and postpartum interventions

Gender and Race Disparities in Cardiovascular Disease Risk Factors among New York City Adults: New York City Health and Nutrition Examination Survey (NYC HANES) 2013–2014

While gender and racial/ethnic disparities in cardiovascular disease (CVD) risk factors have each been well characterized, few studies have comprehensively examined how patterns of major CVD risk factors vary and intersect across gender and major racial/ethnic groups, considered together. Using data from New York City Health and Nutrition Examination Survey 2013–2014—a population-based, cross-sectional survey of NYC residents ages 20 years and older—we measured prevalence of obesity, hypertension, hypercholesterolemia, smoking, and diabetes across gender and race/ethnicity groups for 1527 individuals. We used logistic regression with predicted marginal to estimate age-adjusted prevalence ratio by gender and race/ethnicity groups and assess for potential additive and multiplicative interaction. Overall, women had lower prevalence of CVD risk factors than men, with less hypertension (p = 0.040), lower triglycerides (p \u3c 0.001), higher HDL (p \u3c 0.001), and a greater likelihood of a heart healthy lifestyle, more likely not to smoke and to follow a healthy diet (p \u3c 0.05). When further stratified by race/ethnicity, however, the female advantage was largely restricted to non-Latino white women. Non-Latino black women had significantly higher risk of being overweight or obese, having hypertension, and having diabetes than non-Latino white men or women, or than non-Latino black men (p \u3c 0.05). Non-Latino black women also had higher total cholesterol compared to non-Latino black men (184.4 vs 170.5 mg/dL, p = 0.010). Despite efforts to improve cardiovascular health and narrow disparities, non-Latino black women continue to have a higher burden of CVD risk factors than other gender and racial/ethnic groups. This study highlights the importance of assessing for intersectionality between gender and race/ethnicity groups when examining CVD risk factors

Impact of self-monitoring of BP on the RR of uncontrolled BP at 12 months according to level of co-intervention support (15 studies).

<p>RR of uncontrolled BP adjusted for age, sex, baseline clinic BP, and history of diabetes. The trials are grouped into the 4 levels of intervention, and <i>I</i>² and <i>P</i> values are shown for each level of intervention and for the overall analysis. The effect of self-monitoring on the RR of BP at 6 and 18 months are displayed in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1002389#pmed.1002389.s012" target="_blank">S5</a> and <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1002389#pmed.1002389.s015" target="_blank">S8</a> Figs, respectively. Wakefield study participants self-monitored for 6 months; follow-up continued to 12 months. Abbreviations: BP, blood pressure; RR, relative risk.</p

Impact of self-monitoring of BP on clinic and ambulatory dBP at 12 months (4 studies).

<p>These 4 studies used both clinic and ambulatory BP as endpoints and so are presented in addition to the overall results in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1002389#pmed.1002389.g001" target="_blank">Fig 1</a>, which are for clinic BP alone (including these studies). Change in dBP adjusted for age, sex, baseline clinic BP, history of diabetes, and level of intervention. Effect of self-monitoring on diastolic clinic and ambulatory BP at 6 months is in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1002389#pmed.1002389.s017" target="_blank">S10 Fig</a>. Abbreviations: BP, blood pressure; dBP, diastolic blood pressure.</p

Characteristics of the included studies.

<p>Characteristics of the included studies.</p

Impact of self-monitoring of BP on clinic sBP according to level of co-intervention support at 12 months (15 studies).

<p>Change in sBP adjusted for age, sex, baseline clinic BP, and history of diabetes. The trials are grouped into the 4 levels of intervention, and <i>I</i>² and <i>P</i> values are shown for each level of intervention and for the overall analysis. Effect of self-monitoring on clinic sBP at 6 and 18 months are shown in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1002389#pmed.1002389.s010" target="_blank">S3</a> and <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1002389#pmed.1002389.s013" target="_blank">S6</a> Figs, respectively. Wakefield’s study participants self-monitored for 6 months; follow-up continued to 12 months. Abbreviations: BP, blood pressure; sBP, systolic blood pressure.</p

Impact of self-monitoring of BP on clinic and ambulatory sBP at 12 months (4 studies).

<p>These 4 studies used both clinic and ambulatory BP as endpoints and so are presented in addition to the overall results in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1002389#pmed.1002389.g001" target="_blank">Fig 1</a>, which are for clinic BP alone (including these studies). Change in sBP adjusted for age, sex, baseline clinic BP, history of diabetes, and level of intervention. Effect of self-monitoring on systolic clinic and ambulatory BP at 6 months is in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1002389#pmed.1002389.s016" target="_blank">S9 Fig</a>. Abbreviations: BP, blood pressure; sBP, systolic blood pressure.</p

Impact of self-monitoring of BP on the RR of uncontrolled BP at 12 months according to prespecified subgroups (15 studies).

<p>Obesity defined as BMI ≥ 30 kg/m². RR of uncontrolled BP at 12 months adjusted for age, sex, baseline clinic BP, level of intervention, and studies contributing patient data. Abbreviations: BMI, body mass index; BP, blood pressure; CKD, chronic kidney disease; MI, myocardial infarction; RR, risk ratio; sBP, systolic blood pressure.</p