Childbearing May Increase Visceral Adipose Tissue Independent of Overall Increase in Body Fat

Abstract

Objective: To examine whether childbearing is associated with increased visceral adiposity and whether the increase is proportionally larger than other depots. Methods and Procedures: This prospective study examined changes in adiposity assessed via computed tomography (CT) and dual-energy X-ray absorptiometry among 122 premenopausal women (50 black, 72 white) examined in 1995-1996 and again in 2000-2001. During the 5-year interval, 14 women had one interim birth and 108 had no interim births. Multiple linear regression models estimated mean (95% confidence interval (CI)) 5-year changes in anthropometric and adiposity measures by interim births adjusted for age, race, and changes in total and subcutaneous adiposity. Results: We found no significant differences between one interim birth and no interim births for 5-year changes in weight, BMI, total body fat, subcutaneous adipose tissue, or total abdominal adipose tissue. Visceral adipose tissue increased by 40 and 14% above initial levels for 1 birth and 0 birth groups, respectively. Having 1 birth vs. 0 births was associated with a greater increase in visceral adipose tissue of 18.0 cm 2 (4.8, 31.2), P < 0.01; gain of 27.1 cm 2 (14.5, 39.7) vs. 9.2 cm 2 (4.8, 13.6), and a borderline greater increase in waist girth of 2.3 cm (0, 4.5), P = 0.05; gain of 6.3 cm (4.1, 8.5) vs. 4.0 cm (3.2, 4.8), controlling for gain in total body fat and covariates. Discussion: Pregnancy may be associated with preferential accumulation of adipose tissue in the visceral compartment for similar gains in total body fat. Further investigation is needed to confirm these findings and determine whether excess visceral fat deposition with pregnancy adversely affects metabolic risk profiles among women.

Epidemiology of Abdominal Obesity

“…Parturition was associated with increased WC. It is suggested that after pregnancy, there is a preference for fat accumulation in the visceral adipose tissue [40]. Similarly, in a sample of 170 American women aged 18-76 years, it has been found that the intra-abdominal fat tissue increased as the number of parturitions increased, regardless of age, body fat percentage, physical activity, and smoking [41].…”

Effect of maternal obesity on pregnancy outcomes and long-term metabolic consequences

“…Pregnancy is thought to be associated with preferential accumulation of adipose tissue in the visceral compartment. 28 Regarding the differences in fat distribution observed between lean and obese pregnant women, it seems that the latter gain more fat in the central body compartment compared to the former, who gain more fat in the lower part of the body. 29 …”

“…28,30 The increase of insulin resistance during gestation is paralleled by the progressive increase of maternal adipose tissue deposition. 26 Pregnancy per se is a physiological state of insulin resistance.…”

Reproductive History and Chronic Hepatic Steatosis in the Michigan Study of Women's Health Across the Nation

“…32 Previous studies suggest that weight gained in pregnancy and retained after pregnancy includes fat as opposed to lean mass. [33][34][35][36] We did not find a direct association between cumulative pregnancy weight gain and hepatic steatosis, or number of pregnancies and hepatic steatosis, because pregnancy may not lead to significant accumulations of fat in the liver, even as it leads to increased fat mass and visceral fat deposition. Alternatively, it is possible that the associations between pregnancy and increases in hepatic steatosis during the reproductive years are attenuated as women age; in Michigan SWAN, hepatic steatosis was ascertained approximately 8 years after the menopausal transition.…”