Prevalence and Social and Built Environmental Determinants of Maternal Prepregnancy Obesity in 68 Major Metropolitan Cities of the United States, 2013–2016

Table 4

Logistic models showing unadjusted and covariate-adjusted odds ratios (OR) for prepregnancy obesity, overweight/obesity, and severe obesity according to city-level social and environmental characteristics, United States, 2013–2016 (N = 3,083,600).

	Obesity (BMI ≥ 30)				Overweight/obesity (BMI ≥ 25)				Severe obesity (BMI ≥ 40)
	Unadjusted		Covariate-adjusted^1		Unadjusted		Covariate-adjusted^1		Unadjusted		Covariate-adjusted^1
	OR	95% CI	OR	95% CI	OR	95% CI	OR	95% CI	OR	95% CI	OR	95% CI
Socioeconomic deprivation index, 2008–2012^2
43.85–86.09 (low SES)	1.72	1.71–1.74	1.16	1.15–1.17	1.60	1.58–1.61	1.13	1.12–1.14	2.01	1.97–2.05	1.22	1.19–1.25
86.10–112.64 (middle SES)	1.30	1.29–1.31	1.07	1.06–1.08	1.27	1.26–1.27	1.05	1.04–1.06	1.32	1.29–1.34	1.08	1.06–1.10
112.65–151.24 (high SES)	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference
Violent crime rate/100,000 population, 2015
138.30–478.29 (low crime)	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference
478.30–1108.03	1.09	1.08–1.10	1.00	0.99–1.00	1.06	1.06–1.07	0.97	0.96–0.97	1.17	1.15–1.19	1.04	1.02–1.06
1108.04–1817.10 (high crime)	1.51	1.49–1.52	1.13	1.11–1.14	1.32	1.31–1.33	1.05	1.04–1.06	2.02	1.97–2.06	1.28	1.25–1.31
Physical inactivity (%), 2015^3
14.30–21.75 (low inactivity)	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference
21.76–31.89	1.22	1.21–1.23	1.05	1.04–1.06	1.19	1.18–1.20	1.02	1.02–1.03	1.25	1.23–1.27	1.05	1.03–1.06
31.90–37.10 (high inactivity)	1.41	1.40–1.43	1.05	1.04–1.06	1.35	1.34–1.36	0.99	0.99–1.00	1.54	1.51–1.57	1.13	1.10–1.15
Public transport use for work commute (%), 2008–2012
0.24–1.99 (low use)	1.39	1.37–1.40	1.29	1.28–1.30	1.33	1.32–1.34	1.28	1.27–1.29	1.49	1.46–1.52	1.14	1.11–1.16
2.00–12.03	1.26	1.25–1.27	1.11	1.10–1.12	1.22	1.22–1.23	1.08	1.08–1.09	1.31	1.30–1.33	1.11	1.09–1.14
12.04–55.59 (high use)	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference
Park index score, 2015^4
31.00–42.49 (low access)	1.55	1.53–1.56	1.28	1.27–1.29	1.44	1.43–1.45	1.24	1.23–1.25	1.73	1.70–1.77	1.34	1.32–1.37
42.50–66.49	1.33	1.32–1.34	1.11	1.11–1.12	1.26	1.26–1.27	1.08	1.07–1.08	1.48	1.46–1.50	1.21	1.20–1.23
66.50–84.00 (high access)	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference
Air pollution-annual mean PM2.5 (μg/m^3), 2015
4.70–7.19 (low pollution)	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference	1.00	Reference
7.20–9.69	0.94	0.93–0.95	1.01	1.00–1.02	0.91	0.90–0.92	0.99	0.98–0.99	0.98	0.96–0.99	1.03	1.02–1.05
9.70–14.50 (high pollution)	1.15	1.14–1.16	1.09	1.08–1.10	1.12	1.12–1.13	1.07	1.06–1.08	1.20	1.17–1.22	1.11	1.09–1.14

¹Adjusted for individual-level covariates of race/ethnicity, maternal age, parity, marital status, nativity status, and maternal education. For all city-level covariates, the first category represents the first quintile, the second category represents the second through fourth quintiles, and the third category represents the fifth quintile. ²The socioeconomic deprivation index is a continuous variable with a mean of 100 and a standard deviation of 20. Higher socioeconomic index scores denote higher levels of socioeconomic position and lower levels of deprivation. ³No leisure-time physical activity among adults aged > = 18 years. ⁴The Index, developed by the Trust for Public Land, combines data on the amount of parkland and green spaces, accessibility, investment, and park amenities. Higher park scores indicate better access to and quality of parks, green space, and amenities.