Preconception Cardiometabolic Markers and Birth Outcomes Among Women in the Hispanic Community Health Study/Study of Latinos


Catherine J. Vladutiu, Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services, Rockville, Maryland, USA.
Nicole M. Butera, Biostatistics Center and Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, Maryland, USA.
Daniela Sotres-Alvarez, Department of Biostatistics and the Collaborative Studies Coordinating Center, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
Alison M. Stuebe, Department of Obstetrics & Gynecology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
Larissa Aviles-Santa, National Institute on Minority Health and Health Disparities, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA.
Martha L. Daviglus, Institute for Minority Health Research, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
Marc D. Gellman, Department of Psychology, University of Miami, Coral Gables, Florida, USA.
Carmen R. Isasi, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA.
Christina Cordero, Department of Psychology, University of Miami, Coral Gables, Florida, USA.
Gregory A. Talavera, Department of Psychology, South Bay Latino Research Center, San Diego State University, San Diego, California, USA.
Linda Van Horn, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Anna Maria Siega-Riz, Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA.

Document Type

Journal Article

Publication Date



Journal of women's health (2002)




Hispanics; birth outcomes; cardiometabolic health; metabolic syndrome; preconception; women


Associations between preconception cardiometabolic markers and birth outcomes have been noted, but data are scarce for Hispanics/Latinos. We examined the association between preconception cardiometabolic markers, birthweight and preterm birth among U.S. Hispanic/Latina women. The Hispanic Community Health Study/Study of Latinos is a cohort study of U.S. adults 18-74 years of age, including 3,798 women of reproductive age (18-44 years) from four field centers representing Hispanic/Latino backgrounds of Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American. A baseline clinic examination (2008-2011) and a second clinic examination (2014-2017), including ascertainment of birth outcomes, allowed for identification of 517 singleton live births between the exams. Preconception cardiometabolic markers included abdominal obesity (waist circumference ≥88 cm), body mass index >30 kg/m, high blood pressure (systolic ≥120 mmHg and diastolic ≥80 mmHg), elevated triglycerides (≥150 mg/dL), low high-density lipoprotein cholesterol (<50 mg/dL), elevated fasting glucose (≥100 mg/dL), and insulin. Complex survey linear regression modeled the association between cardiometabolic markers and birthweight-for-gestational age -score; complex survey logistic regression modeled the association with preterm birth. Analyses adjusted for Hispanic/Latina background, field center, years between baseline and birth, age, and nulliparity. In adjusted linear regression models, elevated fasting glucose was associated with higher birthweight -scores (β = 0.56, 95% confidence interval [95% CI] 0.14 to 0.99), even after further adjustment for maternal percent body fat (β = 0.53, 95% CI 0.10 to 0.95). In adjusted logistic regression models, high blood pressure (odds ratio [OR] = 2.57, 95% CI 1.13 to 5.88) and increased insulin (OR = 1.50, 95% CI 1.06 to 2.14, for a 10 mU/L increase) were associated with higher odds for preterm birth. Infant birthweight and preterm birth may be influenced by selected cardiometabolic risk factors before pregnancy among Hispanic/Latina women.


Biostatistics and Bioinformatics