Does WIC Participation During Pregnancy Have an Association with Low Birth Weight and Preterm Birth? Open Access

Morke, Ababa (Spring 2023)

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Introduction: Early access to nutritional services and prenatal care is essential for optimizing birth outcomes. However, evidence on the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and birth outcomes is mixed. We aim to examine the association of WIC participation on low birth weight (LBW) and preterm birth (PTB). We also aim to gain further insight into the association of participation among racially and ethnically different groups in Minnesota.

Methods: The study used birth certificate data from Minnesota for the years 2019-2021, linked with WIC participant information to study the association between WIC participation during pregnancy and LBW and PTB. Logistic regression models were used for the analysis of each outcome. A secondary analysis was conducted to assess these associations stratified among different race/ethnic groups in Minnesota. SAS software was used for statistical analysis, and results were significant if P<0.05

Results: From the sample of 46102, prenatal WIC participation for ≥3 months was associated with a 18% reduction of LBW (AOR 0.82; 95% CI 0.76 - .90; P= <0.0001) and a 21% reduction in the prevalence of PTB (AOR 0.79; 95% CI 0.73 – 0.85; P <0.0001). When stratified by race/ethnicity, East African (AOR 0.65; 95% CI 0.50 – 0.85), Hmong (AOR 0.59; 95% CI 0.40 – 0.86), and White (AOR 0.83; 95% CI 0.72 – 0.97) WIC participants showed statistically significant reductions in the prevalence of LBW compared to non-participants. The Asian/NH/PI, Black/African American, Native American, and Hispanic WIC participants lacked statistical significance. For PTB, East African (AOR 0.68; 95% CI 0.52 – 0.87), Hispanic (AOR 0.77; 95% CI 0.65 – 0.91), and White (AOR 0.82; 95% CI 0.72 - 0.93) WIC participants showed statistically significant reductions in the prevalence of PTB compared to non-participants. The Asian, Black/African American, Hmong, and Native American WIC participants showed protective odds ratios without the statistical significance.

Conclusion: WIC participation was shown to be protective against PTB and LBW. Increasing WIC enrollment in Minnesota could help reduce the prevalence of PTB and LBW. Our findings may help inform future qualitative studies among Minnesota’s racial/ethnic groups to better understand differences in dietary intake, cultural beliefs, or practices that may lead to better outcomes among some groups.

Table of Contents

Chapter 1: Introduction 1

Purpose Statement 3

Objectives 3

Terms/Acronyms & Definitions 3

Chapter 2: Background 4

Existing research 6

Racial disparities in WIC research 9

Chapter II: Methods 10

Data Source 10

Outcome variables 11

Exposure 11

Covariates 11

Analysis 12

Chapter 3: Results 13

Logistic Regression Analysis for LBW 14

Logistic Regression Analysis for PTB 14

Stratifying by Race/Ethnicity 15

Chapter 4: Discussion 17

Chapter 5: Conclusion 21

References 23

Chapter 6: Tables and Figures 26

Figure 1: Sample selection 26

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