Geographic variability in gestational weight gain: a multilevel population-based study of women having term births in Florida (2005-2012).

PURPOSE: We examined the extent of geographic variability in gestational weight gain (GWG), identified areas where women have suboptimal GWG, and evaluated whether individual- and area-level factors account for such variability.

METHODS: We conducted a population-based cohort study including 1,385,574 women delivering term, singleton, and live births in Florida. We used a Bayesian, structured additive regression with a spatial function to analyze data from Florida's birth certificates (2005-2012) and ZIP code tabulation areas (ZCTAs; 2010 Census).

RESULTS: The prevalence of insufficient (7.7%-42.9%) and excessive (17.1%-82.4%) GWG varied widely within Florida. Geographic variability was not explained by risk factors under study. Clusters in Orlando, Tampa, and Miami exhibited increased likelihood of insufficient GWG, whereas clusters in the Northwest of Florida exhibited increased likelihood of excessive GWG.

CONCLUSIONS: We identified areas in Florida with high likelihood of suboptimal GWG that policy-makers should prioritize in the implementation of programs for optimizing GWG.