Do the changes in energy balance that occur during pregnancy predispose parous women to obesity?

Abstract

The aim of this review was to re-assess whether the changes in energy balance that accompany pregnancy predispose parous women to obesity. A number of crosssectional studies have sought to answer this question by examining the relationship between parity and maternal body weight. However, these studies were unable to control for the large number of sociobehavioural confounders that might be responsible for the apparent effect of parity on body weight. Longitudinal studies that examine changes in maternal body weight before and after pregnancy avoid these problems by using each mother as her own control. Nevertheless, these studies have to overcome three methodological constraints: They must obtain an accurate measure of prepregnant body weight, they must give each mother sufficient time to lose any weight retained following delivery, and they must take into account the effect of ageing on maternal weight gain during pregnancy and the follow-up period. More than 90% of the studies reviewed found body weight to be greater after pregnancy than it was before (by 0.2-10.6kg). and previous researchers who have examined the evidence for pregnancy-related weight gains suggest that body weight increases by an average of 0 4 4 4 3 k g following pregnancy. However, only three of the 71 longitudinal studies examined in the present review complied with the three methodological criteria. These studies concluded that mothers gain, on average, 0.9-3.3 kg more weight following pregnancy than nonpregnant controls, and that mean body weight remained 0.4-3.0 kg higher, even after controlling for a number of sociobehavioural confounders. This apparently modest increase in mean maternal body weight for women having one or two children conceals the fact that some mothers experience a substantial increase in body weight and become obese following pregnancy. It remains unclear whether these increases are simply the result of changes in energy metabolism during pregnancy and lactation, or whether they are influenced by inherent changes in lifestyle that accompany pregnancy and motherhood. Understanding the relative importance of these alternatives might help to explain the aetiology of maternal obesity.

Food insecurity and subsequent weight gain in women

“…We found a modest association between having a child during the observational period and weight gain. Other longitudinal studies indicated that women retain between 0.5 and 3 kg in the 2.5 years following pregnancy and that women who gain more than the recommended amount for their pre-pregnancy weight status during pregnancy are significantly more likely to gain additional weight in the postpartum period 19,22 . Although the height and weight data in the PSID are self-reported and subject to reporting and non-response bias 23 , the average amount of weight gain was consistent with measured weight gains from the CARDIA study suggesting that women are gaining 0.7 to 1.2 kg per year on average.…”

Weight development over time in parous women—The SPAWN study—15 years follow-up

“…These results are in line with previous studies that have focused on weight retention after pregnancy. [11][12][13][14][15][16][17][18][19][20][21]46 Moreover, this study is the longest to show an effect on weight gain longitudinally. Ronney and Schauberger 47 have shown similar results on weight development up to 10 y after delivery.…”

“…9,10 Studies report mean weight gains of between 0.4 and 3.8 kg as a result of pregnancy. [11][12][13][14][15][16][17][18][19][20][21] However, patients eventually referred to our obesity unit have reported average weight gains in the region of 10 kg, also for subsequent pregnancies, and viewed this weight gain as an important cause of their obesity. 12 Previous studies have found several factors that could be involved in the course of weight development after pregnancy.…”

Weight Retention Predictors for Taiwanese Women at Six-Month Postpartum

“…Factors that have shown consistent association with postpartum weight gain, and which may contribute to such gains, include GWG (Haiek, Kramer, Ciampi, & Tirado, 2001;Janney, Zhang, & Sowers, 1997;Lovelady, Garner, Moreno, & Williams, 2000) and pre-pregnancy weight (Gunderson, Abrams, & Selvin, 2001;Harris & Ellison, 1997;Muscati, Graydonald, & Koski, 1996;Walker, 1996). In addition, demographic data such as age (Brown, Kaye, & Folsom, 1992), marital status, socioeconomic status, education, parity, breastfeeding, interval between pregnancies, mode of delivery, length of gestation, and tobacco use (Gunderson et al, 2004;Parker & Abrams, 1993) have been related to body weight retention after birth.…”