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Healthcare Policy/Economics

Poster Session 1

(152) Impact of WIC on Hypertensive Disorders in Pregnancy, stratified by BMI category, among Medicaid Participants

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: To investigate whether participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has differential impacts on gestational hypertensive disorders for individuals of different BMI categories.

Study Design: A retrospective cohort study was performed using 2012-2020 national vital statistics patient discharge data from the Centers for Disease Control and Prevention (CDC). The analysis was restricted to data from Medicaid recipients without pre-existing or gestational diabetes, who had non-anomalous, singleton births between 23 and 42 weeks. We compared hypertensive disorders between those who did and did not receive WIC benefits, and further stratified by BMI categories (underweight, normal weight, overweight, and obese). Participants were excluded if they had missing WIC status or BMI data. The outcome of interest was gestational hypertension or pre-eclampsia, which are collapsed in CDC vital statistics. We performed a multivariable logistic regression, controlling for race/ethnicity, age, education, prenatal care, and smoking.

Results:

Of the 12,245,325 Medicaid recipients meeting inclusion criteria, 8,556,373 (69.87%) received WIC benefits. Compared to those without WIC benefits, WIC recipients of all BMI categories had a lower prevalence of gestational hypertension (Figure 1). Multivariable logistic regression demonstrated that the adjusted odds of gestational hypertension or preeclampsia in those who received WIC benefits, relative to those who did not receive WIC benefits, were 0.953 (95% CI: 0.919, 0.989) in underweight individuals, 0.951 (95% CI: 0.941, 0.961) in normal weight individuals, 0.911 (95% CI: 0.902, 0.921) in overweight individuals, and 0.925 (95% CI: 0.917, 0.933) in obese individuals.

Conclusion: Among Medicaid recipients, WIC had a small, inverse association with hypertensive disorders in pregnancy across all BMI categories, with the strongest association demonstrated in overweight and obese individuals.