Excess gains in weight and waist circumference associated with childbearing: The Coronary Artery Risk Development in Young Adults Study (CARDIA)

Abstract

OBJECTIVE:To examine the association of childbearing with weight and waist circumference (WC) changes, we compared women with and without pregnancies or births during follow-up. STUDY DESIGN: A multicenter, longitudinal observational study over 10 years. Comparison groups defined by the number of pregnancies and births during follow-up: P0 (0 pregnancies; nongravid), P1 (1 þ miscarriages or abortions; 'short' pregnancies), B1 (1 birth), and B2 (2 þ births). Mean changes in weight and WC for P1, B1 and B2 groups vs P0 were examined separately by race (black and white), baseline parity (nulliparous and parous) and baseline weight status (normal weight; BMI o25 kg/m 2 and overweight; BMI Z25 kg/m 2 ). SUBJECTS: A population-based sample of 2070 women aged 18-30 y at baseline (1053 black subjects and 1017 white subjects) from Birmingham, Alabama, Chicago, Illinois, Minneapolis, Minnesota, and Oakland, California were examined five times between 1985-1986 and 1995-1996. MEASURMENTS: Weight and WC measurements were obtained using standardized protocol at baseline and examinations at years 2, 5, 7 and 10. Sociodemographic, reproductive, and behavioral attributes were assessed at baseline and follow-up examinations. RESULTS: Gains in weight and WC associated with pregnancy and childbearing varied by race (Po0.001), baseline parity (Po0.05) and overweight status (Po0.001). Among overweight nulliparas, excess gains in weight (black subjects: 3-5 kg, white subjects: 5-6 kg) and WC (black subjects: 3-4 cm, white subjects: 5-6 cm) were associated with 'short' pregnancies and one or more birth(s) during follow-up compared to no pregnancies (Po0.01 and 0.001). Among normal weight nulliparas, excess gains in weight (about 1 kg) and WC (2-3 cm) were associated with follow-up birth(s) (Po0.05). Among women parous at baseline, no excess weight gains were found, but excess WC gains (2-4 cm) were associated with follow-up births. CONCLUSION: Substantial excess weight gain is associated with both short pregnancies and a first birth in women overweight prior to initiation of childbearing. Excess weight gain was not associated with higher order births. Increases in waist girth were cumulative with both first and higher order births among overweight as well as normal weight women. Interventions to prevent obesity should be targeted at women who are overweight prior to initiation of childbearing. The impact of excess WC gains associated with childbearing on women's future health risk should be evaluated further.

Interest in a Twitter-delivered weight loss program among women of childbearing age

“…A third of US women aged 20-39 years are obese [1], and many women experience significant weight gain with pregnancy [2][3][4]. Due to increased risk of pregnancy complications and obesity in offspring [5][6][7][8][9][10], women of childbearing age need efficacious and accessible lifestyle interventions [11,12].…”

Television, Walking, and DietAssociations with Postpartum Weight Retention

“…1,2 Compared with weight gain during other periods of life, excess weight retained after giving birth appears to be particularly harmful, as evidence suggests that it is deposited preferentially in central rather than peripheral sites. 3,4 Postpartum weight retention is defined as the difference between weight at some time after delivery and weight prior to pregnancy. Previous studies indicate that mean postpartum weight retention is approximately 0.5 to 1 kg at 12 months, with a wide range of weight changes from more than 10 kg lost to more than 20 kg gained.…”

New Mothers' Views of Weight and Exercise

“…Excessive pregnancy weight gain has been shown to lead to long term weight retention in studies of several different groups of women, among them White, middle income women (Rooney & Schauberger, 2002), adult women of various ethnicities (Gunderson et al, 2000;Gunderson et al, 2004), and also Black adolescents (Groth, 2008). Rooney and Schauberger, who followed 484 women longitudinally for 15 years (Rooney, Schauberger, & Mathiason, 2005), found that women who did not lose the weight gained during pregnancy by 6 months postpartum were 5.9 kg heavier 8-10 years later than the women who had lost the weight during the first months following childbirth.…”

“…If women gain weight during pregnancy according to the Institute of Medicine (IOM) recommendations, but fail to lose the extra weight by 6 months postpartum, they experience long term weight increases (Rooney & Schauberger, 2002). In addition, pre-pregnant body mass index (BMI) has also been shown to contribute to long term obesity, because women who start pregnancy heavier retain more weight following childbirth (Gunderson et al, 2004;Linne, Dye, Barkeling, & Rossner, 2003).…”