Pregnancy health in a multi-state U.S. population of systemically underserved patients and their children: PROMISE cohort design and baseline characteristics.
| Title: | Pregnancy health in a multi-state U.S. population of systemically underserved patients and their children: PROMISE cohort design and baseline characteristics. |
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| Authors: | Boone-Heinonen J; OHSU-PSU School of Public Health, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd. Mail code: VPT, Portland, OR, USA. boonej@ohsu.edu.; Lyon-Scott K; OCHIN, Inc., Portland, OR, 1881 SW Naito Pkwy, USA.; Springer R; OHSU School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA.; Schmidt T; OCHIN, Inc., Portland, OR, 1881 SW Naito Pkwy, USA.; Vesco KK; Kaiser Permanente Center for Health Research, 3800 N Interstate Ave, Portland, OR, USA.; Booman A; OHSU-PSU School of Public Health, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd. Mail code: VPT, Portland, OR, USA.; Dinh D; OHSU School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA.; Fortmann SP; Kaiser Permanente Center for Health Research, 3800 N Interstate Ave, Portland, OR, USA.; Foster BA; OHSU School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA.; Hauschildt J; OCHIN, Inc., Portland, OR, 1881 SW Naito Pkwy, USA.; Liu S; OHSU School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA.; O'Malley J; OHSU School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA.; OCHIN, Inc., Portland, OR, 1881 SW Naito Pkwy, USA.; Palma A; OHSU-PSU School of Public Health, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd. Mail code: VPT, Portland, OR, USA.; Snowden JM; OHSU School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, USA.; Stratton K; OHSU-PSU School of Public Health, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd. Mail code: VPT, Portland, OR, USA.; Tran S; OHSU-PSU School of Public Health, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd. Mail code: VPT, Portland, OR, USA. |
| Source: | BMC public health [BMC Public Health] 2024 Mar 23; Vol. 24 (1), pp. 886. Date of Electronic Publication: 2024 Mar 23. |
| Publication Type: | Journal Article; Research Support, N.I.H., Extramural |
| Language: | English |
| Journal Info: | Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : BioMed Central, [2001- |
| MeSH Terms: | Pregnancy Complications*/epidemiology ; Gestational Weight Gain*; Obesity/epidemiology ; Overweight/epidemiology ; Pregnancy Outcome/epidemiology ; Pregnancy ; Child ; Female ; Humans ; Infant, Newborn ; Vulnerable Populations ; Pregnancy Trimester, Third ; Body Mass Index |
| Abstract: | Background: Gestational weight gain (GWG) is a routinely monitored aspect of pregnancy health, yet critical gaps remain about optimal GWG in pregnant people from socially marginalized groups, or with pre-pregnancy body mass index (BMI) in the lower or upper extremes. The PROMISE study aims to determine overall and trimester-specific GWG associated with the lowest risk of adverse birth outcomes and detrimental infant and child growth in these underrepresented subgroups. This paper presents methods used to construct the PROMISE cohort using electronic health record data from a network of community-based healthcare organizations and characterize the cohort with respect to baseline characteristics, longitudinal data availability, and GWG.; Methods: We developed an algorithm to identify and date pregnancies based on outpatient clinical data for patients 15 years or older. The cohort included pregnancies delivered in 2005-2020 with gestational age between 20 weeks, 0 days and 42 weeks, 6 days; and with known height and adequate weight measures needed to examine GWG patterns. We linked offspring data from birth records and clinical records. We defined study variables with attention to timing relative to pregnancy and clinical data collection processes. Descriptive analyses characterize the sociodemographic, baseline, and longitudinal data characteristics of the cohort, overall and within BMI categories.; Results: The cohort includes 77,599 pregnancies: 53% had incomes below the federal poverty level, 82% had public insurance, and the largest race and ethnicity groups were Hispanic (56%), non-Hispanic White (23%) and non-Hispanic Black (12%). Pre-pregnancy BMI groups included 2% underweight, 34% normal weight, 31% overweight, and 19%, 8%, and 5% Class I, II, and III obesity. Longitudinal data enable the calculation of trimester-specific GWG; e.g., a median of 2, 4, and 6 valid weight measures were available in the first, second, and third trimesters, respectively. Weekly rate of GWG was 0.00, 0.46, and 0.51 kg per week in the first, second, and third trimesters; differences in GWG between BMI groups were greatest in the second trimester.; Conclusions: The PROMISE cohort enables characterization of GWG patterns and estimation of effects on child growth in underrepresented subgroups, ultimately improving the representativeness of GWG evidence and corresponding guidelines.; (© 2024. The Author(s).) |
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| Grant Information: | R01 DK118484 United States DK NIDDK NIH HHS; 1R01DK118484-01A1 United States NH NIH HHS |
| Contributed Indexing: | Keywords: Body Mass Index; Child; Electronic Health Records; Gestational weight gain; Pregnancy; Retrospective cohort study |
| Entry Date(s): | Date Created: 20240323 Date Completed: 20240325 Latest Revision: 20260216 |
| Update Code: | 20260216 |
| PubMed Central ID: | PMC10960496 |
| DOI: | 10.1186/s12889-024-18257-8 |
| PMID: | 38519895 |
| Database: | MEDLINE |
Journal Article; Research Support, N.I.H., Extramural