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.