A longitudinal study of maternal anthropometric changes in normal weight, overweight and obese women during pregnancy and postpartum

Abstract

Many women associate one or more of their pregnancies with the development of adult obesity. Such an association has not been fully explored. This longitudinal study examines the changes in maternal anthropometric indices during pregnancy and postpartum. Seventy-seven pregnant subjects were investigated longitudinally at about 13, 25 and 36 weeks gestation, of whom fortyseven continued taking part into the postpartum period. Maternal weight, height and skinfold thickness (triceps, biceps, subscapular, suprailiac and mid thigh) were measured at each visit. Maternal fat mass was estimated from the conversion of the first four skinfold thicknesses. Maternal waist and hip circumferences were also measured at the first visit and 6 weeks and 6 months postpartum. Weight and fat gain during pregnancy (13-36 weeks gestation) was 10⋅9 (SD 4⋅7) kg and 4⋅6 (SD 3⋅3) kg (P Ͻ 0⋅001) respectively. A significant increase in fat mass from 13 weeks gestation to 6-months postpartum was observed (2⋅6 (SD 4⋅5), P Ͻ 0⋅001). The increased weight at 6-months postpartum, however, was not statistically significant (1⋅1 (SD 6⋅0) kg, P = 0⋅20). Based on BMI in early pregnancy, the subjects were divided into groups of underweight, normal weight, overweight and obese. The last three groups were compared using ANOVA. The obese group showed a significant difference in the pattern of changes in the skinfold thickness, waist : hip ratio and fat mass at the postpartum period, in comparison with the other two groups. In conclusion, there is a tendency in the obese group to develop central obesity at the postpartum period.

The association of pregnancy and the development of obesity – results of a systematic review and meta-analysis on the natural history of postpartum weight retention

“…Tables 1-3 summarize the results of the qualitative analysis. Fifteen prospective studies, 23,24,[29][30][31][32][33][34][35][36]38,[40][41][42][43][44][45] five retrospective studies, 22,[25][26][27][28]37,46 and the control group from a randomized controlled trial 39 were included in the final analysis. Studies in which women were recruited around the time of delivery and then followed prospectively for postpartum body weight (ambivalent design, as baseline weight was assessed retrospectively) 24,29,30,[34][35][36][44][45][46] were considered as prospective in design, as we wanted to focus on the development of postpartum weight change.…”

“…The majority of studies were conducted in North America [22][23][24]29,35,[37][38][39][40]42,45,46 and Europe, [25][26][27][28]34,36,41,43 where the magnitude of weight retention among women appears to be similar. 39 In developing countries, women retain less weight after pregnancy compared with women in developed countries.…”

“…44 Although these studies included different populations, they did not compromise overall homogeneity as the Brazilian study reported mean reduction rates in weight retention similar to European studies. [25][26][27][28][31][32][33][34]36,41,43 The study participants in the study conducted in China recruited middle class women. 44 (Table 1) All but one 34 study were published in English language.…”

“…[22][23][24][25][26][27][28][29][30][31][32][33][35][36][37][38][39][40][41][42][43][44][45][46] The study populations were mainly recruited from inpatients in departments of obstetrics. [24][25][26][31][32][33]35,36,[38][39][40][41][42][43][44][45][46] There was a higher percentage of low-income women in the studies conducted in North America, but socio-economic status was thought to be homogeneous across studies. 35,37,39,42,45,46 The sample size varied between 47 and 1423 women.…”

“…Six studies had small sample sizes (o100 women). 23,27,28,35,39,41,46 Four studies had sample sizes of over 500 women. 24,36,38,40 Studies were judged homogeneous regarding participants' age.…”