A survey of health behaviors in minority women in pregnancy: The influence of body mass index

Background: An effective behavioral intervention for gestational weight gain in minority obese women needs to incorporate their baseline health behaviors and nutrition patterns. The objective of this study was to compare racial/ethnic differences in health behaviors and nutrition in pregnant obese and non-obese minorities. Methods: A face-to-face, 75-item survey was administered to 94 women (46% non-obese, 54% obese; 71% Black, 29%Hispanic) at a prenatal visit to an inner-city clinic. Television watching, exercise, and nutrition were compared between obese and non-obese women and racial/ethnic differences were compared within each body mass index (BMI) category using chi-square and Fisher's exact tests. Interactions between BMI category and race/ethnicity for each health behavior were examined. Findings: More obese women described their nutrition as "fair" or "poor" (36% vs. 15%; p= .02) and missed more meals per day (21% vs. 6%; p= .03) compared with non-obese women. Obese Blacks were less likely to improve their nutrition during pregnancy compared with obese Hispanics (28% vs. 58%; p= .08). Non-obese Blacks watched more television (p= .03) and exercised less during pregnancy (p= .04) than non-obese Hispanics. Except for dairy products, there were no differences in daily nutrition (fruit, soda, vegetables, chips) among the BMI categories and racial/ethnic groups; however, fewer than 50% of all participants consumed fruits and vegetables every day. There was an interaction between BMI category and race/ethnicity: Obese Hispanics exercised less before pregnancy (p= .02), but exercised more during pregnancy (p= .01) compared with non-obese Hispanics. Conclusions: Interventions for gestational weight gain in obese women may have greater success if they considered racial/ethnic differences in health behaviors, especially related to exercise.