(905) Beyond Gestational Weight Gain: Food Deserts Linked to Higher Early Pregnancy Weight

Obesity, increased gestational weight gain (GWG), & postpartum weight retention (PPWR) are well-established risk factors for adverse perinatal outcomes. While poor diet quality contributes to maternal obesity and metabolic dysfunction, the impact of the local food environment remains unexplored. Food deserts (FD), areas with limited access to nutritious/affordable food, exemplify structural drivers of health disparities. Therefore, we evaluated the association between FD residence during pregnancy and maternal body mass index (BMI), GWG & PPWR.


Study Design:

Using our institutional obstetric database, we performed a retrospective cohort study of all deliveries with documented zip-code & clinical data. FD status was assigned by zip-code of primary residence according to the U.S. Department of Agriculture (USDA) definitions. Maternal BMI was documented at 1^st prenatal & delivery visits. Maternal weight was documented in 1^st trimester (TRI) & postpartum visits. GWG was estimated by calculating change between (Delivery BMI-1^st TRI BMI). PPWR was estimated calculating change between postpartum weight (PPW)-initial prenatal weight (IPW). Kruskal-Wallis & Chi-square tests were performed to compare continuous & categorical variables, respectively.


Results:

Among N=12,968 pregnancies, 33% (n=4,298) lived in a FD. 1^st TRI BMI(30.2±7.9 vs 29.5±7.2, p< 0.01), IPW(177±49.3 vs 171.3±45.2, p< 0.01) & PPW (178.2±48.9 vs 171.1±45.2, p< 0.01) were significantly higher among those who lived in a FD vs those who did not. However, GWG estimated by change in BMI(3.02±3.1 vs 3.07±3.2, p=0.66)) & PPWR(2.5±14.9 vs 2.85±14.4, p=0.62) did not significantly differ between groups.


Conclusion:

While GWG & PPWR did not differ significantly by FD status, those living in FDs began pregnancy at a higher weight and retained a higher weight postpartum. Our data demonstrate residence in a FD is associated with higher maternal weight throughout the perinatal period, which can increase long term cardiometabolic risk. Future studies should investigate underlying sociodemographic factors driving elevated maternal weight in FD populations.