Sugar-sweetened beverage taxes and perinatal health: A quasi-experimental study.

INTRODUCTION: One in five pregnant individuals report consuming sugar-sweetened beverages (SSBs) at least once per day. Excess sugar consumption during pregnancy is associated with several perinatal complications. As SSB taxes become increasingly common public health measures to reduce SSB consumption, evidence on the downstream effects of SSB taxes on perinatal health remains limited.

METHODS: This longitudinal retrospective study examines whether SSB taxes in five US cities were associated with decreased risk of perinatal complications, leveraging 2013-2019 US national birth certificate data and a quasi-experimental difference-in-differences approach to estimate changes in perinatal outcomes. Analysis occurred from April 2021 through January 2023.

RESULTS: The sample included 5,324,548 pregnant individuals and their live singleton births in the US from 2013 through 2019. SSB taxes were associated with a 41.4% decreased risk of GDM (-2.2 percentage points [pp]; 95%CI -4.2, -0.2), a -7.9% reduction in weight-gain-for-gestational-age z-score (-0.2 standard deviations; 95%CI -0.3, -0.01), and decreased risk of infants born small-for-gestational-age (-4.3 pp; 95%CI -6.5, -2.1). There were heterogenous effects across subgroups, particularly for weight-gain-for-gestational-age z-score.

CONCLUSIONS: SSB taxes levied in five US cities were associated with improvements in perinatal health. SSB taxes may be an effective policy instrument for improving health during pregnancy, a critical window during which short-term dietary exposures can have lifelong consequences for the birthing person and child.