Table 1. Changes in Gestational Weight Gain (GWG) Before and During the COVID-19 Pandemic by Maternal Characteristics.
| Maternal characteristic | Prepandemic year 2018 | Prepandemic year 2019 | Pandemic year 2020 | Adjusted changes in GWG, mean (95% CI), kga | Net change during pandemic, mean (95% CI), kgb | ||||
|---|---|---|---|---|---|---|---|---|---|
| No. (%) | GWG, mean (SD), kg | No. (%) | GWG, mean (SD), kg | No. (%) | GWG, mean (SD), kg | 2019 vs 2018 | 2020 vs 2019 | ||
| Total | 2 475 822 (100) | 13.28 (6.85) | 2 486 122 (100) | 13.26 (6.84) | 2 847 592 (100) | 13.31 (6.85) | 0.03 (0.02 to 0.05) | 0.09 (0.08 to 0.10) | 0.06 (0.04 to 0.07) |
| Age, y | |||||||||
| <25 | 597 905 (24.1) | 13.60 (7.31) | 589 056 (23.7) | 13.59 (7.30) | 652 564 (22.9) | 13.81 (7.36) | 0.04 (0.01 to 0.07) | 0.26 (0.24 to 0.29) | 0.22 (0.19 to 0.26) |
| 25-29 | 722 167 (29.2) | 13.24 (6.91) | 718 612 (28.9) | 13.24 (6.91) | 808 139 (28.4) | 13.28 (6.91) | 0.06 (0.03 to 0.08) | 0.09 (0.07 to 0.11) | 0.03 (0 to 0.06) |
| 30-34 | 713 137 (28.8) | 13.29 (6.54) | 722 169 (29.0) | 13.26 (6.53) | 844 536 (29.7) | 13.23 (6.53) | 0.01 (−0.01 to 0.03) | 0.01 (−0.01 to 0.03) | 0 (−0.03 to 0.03) |
| ≥35 | 442 613 (17.9) | 12.91 (6.59) | 456 285 (18.4) | 12.89 (6.56) | 542 353 (19.0) | 12.87 (6.56) | 0.02 (0 to 0.05) | 0 (−0.03 to 0.02) | −0.02 (−0.06 to 0.01) |
| Educational attainment | |||||||||
| High school or less | 937 032 (37.8) | 12.76 (7.31) | 939 208 (37.8) | 12.73 (7.30) | 1 071 703 (37.7) | 12.86 (7.34) | 0.03 (0.01 to 0.05) | 0.19 (0.17 to 0.21) | 0.16 (0.13 to 0.19) |
| Some college | 492 995 (19.9) | 13.32 (7.23) | 485 850 (19.5) | 13.33 (7.24) | 539 398 (18.9) | 13.45 (7.25) | 0.08 (0.05 to 0.10) | 0.17 (0.15 to 0.20) | 0.10 (0.06 to 0.14) |
| Associate’s degree | 207 092 (8.4) | 13.38 (6.84) | 207 219 (8.3) | 13.35 (6.84) | 237 831 (8.4) | 13.39 (6.86) | 0.04 (0.00 to 0.08) | 0.09 (0.05 to 0.13) | 0.05 (−0.01 to 0.10) |
| Bachelor’s degree | 505 845 (20.4) | 13.84 (6.10) | 511 813 (20.6) | 13.82 (6.08) | 600 393 (21.1) | 13.75 (6.10) | 0.01 (−0.01 to 0.04) | −0.04 (−0.07 to −0.02) | −0.06 (−0.09 to −0.02) |
| Master’s degree or higher | 302 663 (12.2) | 13.93 (5.76) | 308 812 (12.4) | 13.89 (5.75) | 362 104 (12.7) | 13.73 (5.77) | 0.00 (−0.03 to 0.02) | −0.14 (−0.17 to −0.12) | −0.14 (−0.18 to −0.10) |
| Unknown | 30 195 (1.2) | 12.43 (6.53) | 33 220 (1.3) | 12.41 (6.52) | 36 163 (1.3) | 12.42 (6.63) | 0.02 (−0.08 to 0.12) | 0.14 (0.05 to 0.23) | 0.12 (−0.02 to 0.25) |
| Race or ethnicity | |||||||||
| Hispanic | 563 214 (22.7) | 12.31 (6.61) | 581 543 (23.4) | 12.30 (6.55) | 686 707 (24.1) | 12.40 (6.58) | 0.04 (0.02 to 0.06) | 0.12 (0.10 to 0.14) | 0.08 (0.05 to 0.11) |
| Non-Hispanic Black | 359 741 (14.5) | 12.62 (7.61) | 363 839 (14.6) | 12.63 (7.60) | 408 663 (14.4) | 12.75 (7.57) | 0.05 (0.02 to 0.08) | 0.17 (0.14 to 0.20) | 0.12 (0.07 to 0.16) |
| Non-Hispanic White | 1 299 100 (52.5) | 13.98 (6.76) | 1 284 053 (51.6) | 13.96 (6.77) | 1 459 631 (51.3) | 13.98 (6.78) | 0.02 (0.00 to 0.03) | 0.05 (0.04 to 0.07) | 0.04 (0.01 to 0.06) |
| Otherc | 96 865 (3.9) | 13.46 (7.31) | 98 515 (4.0) | 13.47 (7.31) | 111 782 (3.9) | 13.64 (7.41) | 0.07 (0.01 to 0.13) | 0.22 (0.16 to 0.28) | 0.15 (0.06 to 0.23) |
| Marital status | |||||||||
| Married | 1 256 522 (50.8) | 13.38 (6.48) | 1 257 871 (50.6) | 13.36 (6.46) | 1 496 696 (52.6) | 13.32 (6.43) | 0.02 (0.01 to 0.04) | 0.01 (−0.01 to 0.02) | −0.01 (−0.04 to 0.01) |
| Unmarried | 858 511 (34.7) | 13.39 (7.54) | 874 752 (35.2) | 13.35 (7.55) | 1 019 932 (35.8) | 13.46 (7.57) | 0.03 (0.01 to 0.06) | 0.20 (0.18 to 0.22) | 0.16 (0.13 to 0.19) |
| Unknown | 360 789 (14.6) | 12.71 (6.37) | 353 499 (14.2) | 12.71 (6.26) | 330 964 (11.6) | 12.76 (6.32) | 0.07 (0.04 to 0.09) | 0.12 (0.09 to 0.14) | 0.05 (0.01 to 0.09) |
| APNCU indexd | |||||||||
| Inadequate | 330 942 (13.4) | 12.20 (7.35) | 336 462 (13.5) | 12.18 (7.33) | 386 160 (13.6) | 12.29 (7.31) | 0.05 (0.02 to 0.09) | 0.14 (0.11 to 0.17) | 0.09 (0.04 to 0.14) |
| Intermediate | 76 071 (3.1) | 12.78 (6.94) | 73 084 (2.9) | 12.74 (6.92) | 115 526 (4.1) | 12.91 (6.80) | 0.03 (−0.04 to 0.10) | 0.15 (0.09 to 0.21) | 0.13 (0.03 to 0.22) |
| Adequate | 313 184 (12.6) | 13.46 (6.67) | 307 518 (12.4) | 13.40 (6.66) | 419 867 (14.7) | 13.51 (6.62) | 0.01 (−0.03 to 0.04) | 0.12 (0.09 to 0.15) | 0.12 (0.07 to 0.16) |
| Adequate plus | 1 698 163 (68.6) | 13.49 (6.74) | 1 714 243 (69.0) | 13.47 (6.73) | 1 863 179 (65.4) | 13.50 (6.77) | 0.03 (0.02 to 0.05) | 0.07 (0.06 to 0.08) | 0.04 (0.02 to 0.06) |
| Unknown | 57 462 (2.3) | 13.23 (7.41) | 54 815 (2.2) | 13.26 (7.33) | 62 860 (2.2) | 13.22 (7.36) | 0.11 (0.02 to 0.19) | 0.00 (−0.08 to 0.08) | −0.11 (−0.23 to 0.01) |
| BMI before pregnancy | |||||||||
| Underweight (<18.5) | 81 528 (3.3) | 15.10 (6.16) | 78 554 (3.2) | 15.18 (6.18) | 83 528 (2.9) | 15.11 (6.28) | 0.10 (0.04 to 0.16) | −0.07 (−0.13 to −0.01) | −0.17 (−0.26 to −0.09) |
| Normal weight (18.5-24.9) | 1 051 356 (42.5) | 14.72 (6.00) | 1 030 093 (41.4) | 14.71 (6.00) | 1 157 553 (40.7) | 14.71 (6.03) | 0.01 (0.00 to 0.03) | 0.01 (−0.01 to 0.02) | −0.01 (−0.03 to 0.02) |
| Overweight (25.0-29.9) | 657 042 (26.5) | 13.48 (6.91) | 666 751 (26.8) | 13.51 (6.86) | 770 820 (27.1) | 13.58 (6.86) | 0.04 (0.02 to 0.07) | 0.09 (0.07 to 0.11) | 0.04 (0.01 to 0.08) |
| Obesity (≥30) | 685 896 (27.7) | 10.67 (7.33) | 710 724 (28.6) | 10.72 (7.29) | 835 691 (29.3) | 10.93 (7.30) | 0.05 (0.02 to 0.07) | 0.22 (0.20 to 0.24) | 0.17 (0.14 to 0.21) |
| Payment source for delivery | |||||||||
| Medicaid | 1 034 348 (41.8) | 12.87 (7.38) | 1 031 578 (41.5) | 12.84 (7.36) | 1 179 455 (41.4) | 12.99 (7.38) | 0.04 (0.02 to 0.06) | 0.21 (0.19 to 0.23) | 0.17 (0.15 to 0.20) |
| Private insurance | 1 235 811 (49.9) | 13.69 (6.40) | 1 251 825 (50.4) | 13.67 (6.40) | 1 443 554 (50.7) | 13.61 (6.41) | 0.03 (0.02 to 0.05) | −0.02 (−0.04 to −0.01) | −0.05 (−0.08 to −0.03) |
| Self-pay | 99 501 (4.0) | 12.42 (6.31) | 102 183 (4.1) | 12.39 (6.33) | 108 310 (3.8) | 12.52 (6.33) | 0.03 (−0.02 to 0.08) | 0.13 (0.08 to 0.19) | 0.11 (0.03 to 0.18) |
| Other | 95 451 (3.9) | 13.40 (6.76) | 88 249 (3.5) | 13.42 (6.75) | 97 904 (3.4) | 13.58 (6.82) | 0.01 (−0.05 to 0.07) | 0.19 (0.13 to 0.24) | 0.18 (0.09 to 0.26) |
| Unknown | 10 711 (0.4) | 13.50 (7.28) | 12 287 (0.5) | 13.45 (7.00) | 18 369 (0.6) | 13.47 (7.08) | −0.04 (−0.21 to 0.14) | 0.09 (−0.06 to 0.25) | 0.13 (−0.11 to 0.36) |
| Gestational age, wk | |||||||||
| Very and moderate preterm (<35) | 67 214 (2.7) | 10.32 (7.00) | 70 351 (2.8) | 10.38 (6.95) | 76 994 (2.7) | 10.42 (6.99) | 0.10 (0.03 to 0.17) | 0.08 (0.01 to 0.16) | −0.02 (−0.12 to 0.09) |
| Late preterm (35-36) | 179 705 (7.3) | 12.22 (7.00) | 190 637 (7.7) | 12.25 (6.98) | 214 568 (7.5) | 12.30 (7.02) | 0.08 (0.03 to 0.12) | 0.12 (0.07 to 0.16) | 0.04 (−0.02 to 0.10) |
| Term (37-41) | 2 105 914 (85.1) | 13.45 (6.79) | 2 100 087 (84.5) | 13.43 (6.78) | 2 410 281 (84.6) | 13.47 (6.78) | 0.03 (0.01 to 0.04) | 0.08 (0.07 to 0.10) | 0.06 (0.04 to 0.08) |
| Postterm (>41) | 122 989 (5.0) | 13.66 (7.17) | 125 047 (5.0) | 13.64 (7.11) | 145 749 (5.1) | 13.66 (7.12) | 0.07 (0.01 to 0.12) | 0.12 (0.06 to 0.17) | 0.05 (−0.02 to 0.12) |
Abbreviations: APNCU, adequacy of prenatal care utilization; BMI, body mass index (calculated as weight in kilograms divided by height in meters squared).
a
We mutually adjusted all variables in the table in linear regressions.
b
Net changes during the pandemic were calculated as GWG for 2020 vs 2019 minus GWG for 2019 vs 2018, and the corresponding 95% CIs were calculated as the square root of the sum of the squares of the separate SEs.
c
Includes non-Hispanic American Indian or Alaskan Native, non-Hispanic with more than 1 race, and unknown or undisclosed race or ethnicity.
d
The APNCU index was calculated based on the month in which prenatal care is initiated and the number of visits from initiation of care until delivery. It is categorized into 4 levels: inadequate care is defined as starting prenatal care after the fourth month of pregnancy or receiving less than 50% of expected visits based on the schedule of prenatal care visits recommended by the American College of Obstetricians and Gynecologists; intermediate care is care begun by month 4 with 50% to 79% of expected visits received; adequate care is begun by month 4 with 80% to 109% of expected visits received; and adequate plus care is begun by month 4 with 110% or more of expected visits received.