Associations between reproduction and maternal body weight: examining the component parts of a full reproductive cycle

Abstract

Objective: Many transitional societies currently face both extremes of nutritional status, undernutrition and overnutrition. Women of reproductive age are at high risk of these conditions. The purpose of this review is to consider evidence for relationships between reproduction and nutritional status in women from societies of varying economic development, using body weight or weight-for-height as indicators of maternal nutritional status. Design: The conceptual framework guiding this review is that the duration of the reproductive cycle varies as a function of its component parts, which include (i) pregnancy, (ii) lactation, (iii) the non-pregnant=non-lactating (NP=NL) interval or, possibly, (iv) an overlap between lactation and next pregnancy. All component parts of the complete cycle vary in length and are associated with changes in nutritional status. A variety of factors ('proximal and distal determinants') influence the duration of the component parts of the reproductive cycle. This framework is used to examine current knowledge of changes in maternal nutritional status during each of these parts. Results: Women in affluent societies retain some weight with each pregnancy, beyond that of non-pregnant women. Women in less affluent societies retain less weight with each pregnancy. During lactation, women in both affluent and less affluent societies experience only modest weight loss. During the NP=NL interval, women in affluent societies tend to gain weight, whereas weight of women in less affluent societies is likely to fluctuate. Conclusions: We conclude that there is a dearth of information on certain parts of the cycle, particularly the periods of overlap of lactation with pregnancy and the NP=NL interval.

20-Year Trends in Filipino Women's Weight Reflect Substantial Secular and Age Effects

“…While parity-related increases in maternal weight are often observed in well-nourished women (27,28), depletion of maternal energy reserves may result from limited dietary intake and high levels of reproductive stress in women from lower income countries (27,29,30). We observed that while higher parity was related to higher weight, a greater number of months pregnant and lactating in each interval related to lower body weight, consistent with the high energy demands of these reproductive stresses.…”

Parental BMI and Childhood Undernutrition in India: An Assessment of Intrauterine Influence

“…The implicit assumption, therefore, is that the "postnatal" and "prenatal" maternal and paternal BMI are strongly correlated. 48 Women in less affluent societies have been shown to retain less weight with each pregnancy, 49 although the evidence for maternal weight loss as a result of their prepregnancy undernutrition remains unclear. Overlapping of closely spaced pregnancies with the lactation period, however, could lead to loss of maternal body weight.…”

Country development and the association between parity and overweight

“…[4][5][6][7] Excessive gestational weight gain and the inability to lose this weight in the postpartum period are thought to be two of the main ways in which reproduction contributes to overweight. 4,5,[8][9][10] In developing countries, frequent reproductive cycles (especially when accompanied by short or absent recuperative intervals, that is periods free from pregnancy or breastfeeding) have been suggested as a risk factor for maternal depletion. 11 Poor dietary intake and heavy activity patterns further exacerbate the nutritional and energetic stress of frequent reproductive cycles, such that nutritional status deteriorates over time.…”