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Session: From the Womb to the World: Impact of Prenatal and Perinatal Exposures on Offspring Outcomes (Oral 21)

(OR21-02-23) WIC Participation Is Associated With Recommended Gestational Weight Gain and Lower Birthweight in Texas

Monday, July 24, 2023

4:12 PM – 4:24 PM ET

Location: Constitution B

Presenting Author(s)

Elizabeth M. Widen, PhD, RD

Assistant Professor
The University of Texas at Austin
Austin, Texas, United States

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

EK

Eliza W. Kinsey

University of Pennsylvania, Perelman School of Medicine
AR

Andrew G. Rundle

Columbia University
CC

Catherine Cubbin, PhD

Professor
The University of Texas at Austin
Austin, Texas, United States
Marissa Burgermaster, PhD (she/her/hers)

Assistant Professor
The University of Texas at Austin
Austin, Texas, United States
SD

Sara Dube

The University of Texas at Austin
Saralyn F. Foster, MS, RDN, LD (she/her/hers)

Doctoral Candidate
The University of Texas at Austin
Austin, Texas, United States
Rachel R. Rickman, PhD, MS, RD (she/her/hers)

Graduate
The University of Texas at Austin
Austin, Texas, United States
MA

Marcela Abrego

The University of Texas at Austin
MW

Michelle Wright

The University of Texas at Austin

Disclosure(s):

Elizabeth M. Widen, PhD, RD: No relevant financial relationship(s) with ineligible companies to disclose.

Saralyn F. Foster, MS, RDN, LD: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: WIC is designed to support prenatal and postpartum nutrition and perinatal outcomes. It is unknown how WIC participation impacts gestational weight gain (GWG) and birth size, and whether effects among Hispanics vary by nativity and living near the Texas-Mexico border. We examined how WIC receipt was associated with GWG and perinatal outcomes in Texas, and whether WIC differentially impacted outcomes among Hispanic people by proximity to the Texas-Mexico border and nativity.

Methods: Data were from 2014 Texas Vital Statistics birth records of term singleton pregnancies among those >18 years (N=248,944, 47% Hispanic of whom 42% are foreign born). Multinomial, Poisson and linear regression models related WIC receipt (46%) to GWG adequacy (excessive, low, or recommended by 2009 IOM guidelines), and gestational-age standardized birthweight, as well as large- (LGA) and small-for-gestational age (SGA), controlling for covariates. Additional models examined if effects of WIC among Hispanic people differed by nativity and border residence.

Results: Overall, half of pregnancies (51%) experienced excessive GWG, while 19% had inadequate GWG and 30% were within the guidelines. Pregnancies supported by WIC were 9% (RR 0.91, 95% CI 0.88,0.93) and 7% (RR 0.93, 95% CI 0.91,0.95) less likely to have inadequate or excessive GWG, respectively, compared to adequate GWG; whereas WIC was associated with 0.01 (95% CI -0.02,-0.003) lower birthweight Z-scores and a 4% increased risk of SGA (RR 1.04, 95% CI: 1.01, 1.07), but not LGA. Among foreign born Hispanic people, WIC was not associated with birth size, yet, effects of WIC on GWG varied by border residence. Among foreign born Hispanic people not living at the border, WIC was associated with a lower likelihood of excessive (RR 0.85, 95% CI: 0.80, 0.90), and inadequate GWG (RR 0.73, 95% CI: 0.69, 0.78), while among border residents, WIC was associated with a higher likelihood of excessive (RR 1.19, 95% CI: 0.80, 0.89) and inadequate GWG (RR 1.16, 95% CI: 1.02, 1.32). Among Hispanic US born people, WIC was not associated with GWG or birth size.

Conclusions: In Texas in 2014, receipt of WIC was associated with more favorable GWG and neonatal birth weight; however, among Hispanic people, the effects of WIC on GWG varied by nativity and proximity to the Texas-Mexico border, suggesting differential impact in these populations.

Funding Sources: NICHD