Trends in Gestational Weight Gain and Prepregnancy Obesity in South Carolina, 2015–2021

PEER REVIEWED

Of 266,146 mothers in South Carolina with at least 1 pregnancy from 2015 through 2021, we excluded 671 mothers with inconsistent age across pregnancies, defined as varying by more than ±2 years; 159 who did not have a live birth during the study period; 881 who gave birth in South Carolina but did not reside in South Carolina (331,979 of these births linked to a hospital and/or ED visit for the baby, whereas 12,963 did not); 64 mothers (100 pregnancies) with triplet and quadruplet births; 6,417 mothers (6,058 pregnancies) with twin births; and 18,357 mothers (32,440 pregnancies) who did not have full term (≥37 weeks) singleton births. The final dataset was limited to 239,597 mothers with 1 or more live, full term, singleton births (306,344 pregnancies) in South Carolina over the study period.

Figure 1.
Flowchart of exclusion criteria for study sample, study of trends in gestational weight gain and prepregnancy obesity in South Carolina, 2015 through 2021.

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Panel A: Prevalence of inadequate weight gain increased across all racial and ethnic groups prior to the pandemic (2020, quarter 1) but attenuated after the pandemic across all groups. Panel B: Prevalence of excessive weight gain was high and remained stable across all racial and ethnic groups before (2020, quarter 1) and after the pandemic. Panel C: Prevalence of adequate weight gain decreased slightly prior to the pandemic (2020, quarter 1) but increased after the pandemic across all racial and ethnic groups.

Figure 2.
Prevalence of 3 categories of gestational weight gain among women with 1 or more full-term (≥37 weeks) singleton births in South Carolina, by race or ethnicity, from 2015 through 2021: inadequate weight gain (Panel A), excessive weight gain (Panel B), and adequate weight gain (Panel C). Thick black vertical line indicates the start of the COVID-19 pandemic. Dotted lines indicate 95% CIs. Other race or ethnicity includes women who self-identified as Asian, American Indian/Alaska Native, Native Hawaiian/Other Pacific Islander or those whose race/ethnicity was missing. Abbreviation: Q, quarter of year.

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The prevalence of prepregnancy obesity increased across all racial and ethnic groups prior to the pandemic (2020, quarter 1); however, after the pandemic, the prevalence increased only among women of “other” races and ethnicities, while attenuating among Non-Hispanic White, Non-Hispanic Black and Hispanic women.

Figure 3.
Prevalence of prepregnancy obesity among women with 1 or more full term (≥37 weeks) singleton births in South Carolina, by race and ethnicity, from 2015 through 2021. The change point was the start of the COVID-19 pandemic, quarter (Q) 1, the first quarter of 2020.Dotted lines indicate 95% CIs.

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