Association Between Social Determinants of Health Issues and Maternal Obesity Among American Racial/Ethnic Groups.

Background and Objective: Social determinants of health impact various clinical health outcomes in the population. We conducted this study to examine the impact of adverse social determinants of health (SDOH) characteristics on maternal obesity among hospitalized pregnant women in the US and its potential differential impact on women of different races/ethnicities. Methods: The nationwide pregnancy hospitalization data analyzed in this study were collected through the Nationwide Inpatient Sample (NIS) database during 2016-2018. We conducted descriptive analyses to evaluate the relationship between patient characteristics and maternal obesity. Using the adjusted survey logistic regression model, we calculated the independent association between social determinants of health (SDOH) risk factors and hospitalization characteristics (exposure) and maternal obesity (outcome). Lastly, stratified survey logistic regression models were created for each racial/ethnic group to examine the differential impact in the association between SDOH issues and maternal obesity. Results: The prevalence of SDOH issues was highest in non-Hispanic (NH) Black women (6.59 per 1000 hospitalizations), whereas the prevalence of obesity among those with SDOH issues was highest in Hispanic women (15.3 per 100 hospitalizations). We observed that pregnant women with SDOH issues were 1.15 times as likely (95% CI: 1.05-1.25) to experience maternal obesity compared to those without SDOH issues. Relative to their counterparts without SDOH issues, Hispanics and NH-Others with SDOH issues had increased odds of obesity, whereas NH-White and NH-Black mothers with SDOH had similar odds of obesity (p>0.05). Conclusion and Global Health Implications: In conclusion, pregnant women with SDOH issues had an increased likelihood of obesity diagnosis and the association demonstrated differential impact across racial/ethnic sub-populations. This information has potential utility for counseling and formulation of targeted interventions for pregnant women.