Abstract
OBJECTIVES: The objective of this study was to examine trends in pre-pregnancy obesity among WIC-participating mothers between 2000–2016 across twenty U.S. states. METHODS: Data on self-reported maternal pre-pregnancy body mass index (BMI, kg/m2) were obtained from publicly available records and trends were analyzed for states with data for all selected years (2000–2016; n = 20). Pre-pregnancy obesity was defined as BMI ≥30 kg/m2. Trends were adjusted for race, ethnicity, and median education. RESULTS: Overall, all states experienced a significant increase in the prevalence of pre-pregnancy obesity from 2000 until 2016. Noteworthy trends were found in several states: 1) Alabama consistently had the highest prevalence of pre-pregnancy obesity, ranging from 31.8% in 2000 to 42.8% in 2016. 2) Wisconsin had the most significant increase of the 20 states, increasing from 22.4% in 2000 to 42.3% in 2016 (annual % change [APC] = 6%). 3) Michigan had a significant increase in prevalence between 2000 and 2006, from 27.9% in 2000 to 32.5% in 2006 (APC = 2.5%), but then plateaued at 33% from 2006–2016. 4) Vermont had a significant increase from 2000–2012 (29% to 36.5%), but then experienced a decline from 2012 to 2016 (36.5% to 33.4%). CONCLUSIONS: These findings suggest that obesity interventions should be targeted at women before they start their reproductive lives. Identifying ways to support a healthy gestational weight gain within WIC may ameliorate the negative consequences associated with pre-pregnancy obesity on both women and children, especially since most women join WIC when they are already pregnant, if not later. FUNDING SOURCES: This research was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under the grant: Maternal and Child Health Nutrition Training Program. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government.