The Impact of SNAP Participation on Pregnancy Weight Related Outcomes and Program Participation of Pregnant WIC Participants in Arizona; a Cross Sectional Study

Purpose: Although numerous studies exist regarding the health impact of the Special, Supplemental Program for Women, Infants and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP) on their participants’, limited studies have examined how participation in one federal nutrition assistance program, may impact participation or perceived benefit of the other. This study aimed to examine how SNAP participation may impact weight-related pregnancy outcomes and participation of pregnant WIC participants. Methods: The present study is a cross-sectional, secondary data analysis of data available from the Arizona Department of Health Services. A total of 35,659 pregnant woman participated in the Arizona WIC program during 2018 and were included in the study. Pregnant participants were assigned to Group WIC or Group WIC+SNAP respectively. Data was aggregated to the clinic level and clinics with less than 10 pregnant participants were combined for a total of 101 clinics included in the analysis. Weight-related pregnancy outcomes measures included average pre-pregnancy weight, average gestational weight gain, BMI class, and delivery weight. Participation indicator outcomes included average number of visits during pregnancy, timing of first prenatal and postnatal WIC appointment, and entry into WIC within the first trimester. Race, ethnicity, language, and education were also analyzed. Results: This study found average pre-pregnancy weight was statistically significant for women in group SNAP+WIC weighing 2.8 kg more than women in group WIC(p<0.001). Group WIC had a lower delivery weight average (p<0.001) and a higher amount of women beginning pregnancy with a normal BMI (p=0.004). Group WIC participants were statistically more likely to not enroll in WIC during the first trimester compared with Group WIC+SNAP (p=0.049). Group WIC was more likely to enroll in the 8th (p=0.045) and 9th month (p=0.009) of pregnancy and attend their first postpartum visit 6 months after delivery (p=0.007) as compared to Group WIC+SNAP. Conclusions: This study found that pregnant WIC participants, not enrolled in SNAP have a lower pre-pregnancy weight and are more likely not to enroll within the first trimester. Future research should focus on individualized characteristics of WIC participants to further improve prenatal and postnatal support.