(P37-10-26) Is Neighborhood Deprivation Associated Among Mothers With Overweight or Obesity?

Objectives: To examine the association of neighborhood deprivation with breastfeeding outcomes among mothers entering pregnancy with overweight and obesity.

Methods: This is a cohort secondary analysis of the Goals for Reaching Optimal Wellness RCT (n=454) that included a dietary intervention focused on achieving appropriate gestational weight gain and limiting postpartum weight retention in pregnant women with overweight and obesity in California. Participants’ addresses were geocoded, and 2021 tract-level data were extracted from the Census Bureau’s American Community Survey to align with recruitment (2021-2022). Principal component analysis was used to construct the Neighborhood Deprivation Index (NDI). Final score was standardized with a mean of 0 and an SD of 1, with higher scores representing greater deprivation. Binary outcomes included breastfeeding initiation and exclusivity at 3 and 6 mos. Modified Poisson regression examined associations between NDI score and breastfeeding outcomes adjusted for maternal sociodemographics and intervention arm.

Results: The final analytical sample included participants with at least one breastfeeding outcome and a tract-linked address (n=354). Mean (SD) age and BMI of mothers were 33.6 (4.1) years, and 30.9 (4.2) kg/m². Most (70%) had a college degree or more, a previous child (57%), initiated breastfeeding (90.7%), and breastfed exclusively for 3 mos (70.1%), but not for 6 mos (42.7%). Final NDI was derived from the first component, explaining 54% of the variance. Contributing variables were professional occupations, renter-occupied units, crowded households, female-headed households with children, high school education, poverty level, and households earning < $45,000. In adjusted models, NDI score was not associated with breastfeeding initiation (RR=1.01; 95%CI: 0.97, 1.05), exclusivity at 3 mos (RR=1.00; 95%CI: 0.91, 1.10), or at 6 mos (RR=0.93; 95%CI: 0.78, 1.12).

Conclusions: NDI was not associated with breastfeeding outcomes, which may reflect participants being among the most educated and higher economic status relative to their neighborhood. Future studies should explore how individual social determinants may modify the impact of neighborhood disadvantage on breastfeeding practices.

Funding Sources: UCD Dissertation Fellowship, DREAMS P30DK092924, NINR R01NR017659