Document Type

Open Access Thesis

Embargo Period

10-4-2015

Degree Program

Public Health

Degree Type

Master of Science (M.S.)

Year Degree Awarded

2015

Month Degree Awarded

May

Abstract

Preterm birth affects 12% of infants in the United States annually and is the main contributor to infant deaths and long-term neurological disabilities in offspring. Obesity is a growing problem in the U.S., and is increasingly being considered a major risk factor for adverse health outcomes. Puerto Rican teenagers have disproportionately high rates of preterm birth and obesity when compared to non-Hispanic White teenagers. Studies evaluating risk factors for preterm birth among adolescents are sparse, have inconsistent findings, and were conducted among predominantly non-Hispanic populations. Therefore, we investigated the association between BMI and preterm birth among the 419 teenage (ages 16-19) participants in Proyecto Buena Salud, a prospective cohort study of predominantly Puerto Rican prenatal care patients in Massachusetts. Pre-pregnancy BMI was abstracted from medical records and defined using CDC adolescent BMI-for-age percentile categories. Preterm birth classifications were abstracted from the delivery record and confirmed by the study obstetrician. Seventy-six (18%) participants were overweight and 58 (14%) were obese. A total of 49 (11.7%) preterm births were observed, consisting of 36 (73%) spontaneous and 13 (27%) medically indicated. After adjusting for pregnancy complications, previous preterm birth, age, acculturation, and gestational weight gain, obese teens had a reduced odds of total preterm birth (OR: 0.12, 95% CI: 0.02, 0.61) and had a mean gestational age at delivery of 0.9 weeks higher (95% CI: 0.19, 1.56) as compared to normal weight teens. When evaluating preterm birth by subtype, overweight/obese teens had a reduced odds of spontaneous (OR: 0.36, 95% CI: 0.13, 1.02) and medically indicated (OR: 0.054, 95% CI: 0.004, 0.70) preterm birth compared to normal weight teens. This study adds to the body of literature on the impact of obesity on birth outcomes and extends this work to Hispanic teenagers.

First Advisor

Lisa Chasan-Taber

Second Advisor

Penelope S. Pekow

Third Advisor

Brian W. Whitcomb

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