Gestational Weight Gain as a Predictor of Longitudinal Body Mass Index Transitions Among Socioeconomically Disadvantaged Women

Abstract

Background: Socioeconomically disadvantaged women are at greater risk for gestational weight gain and postpartum weight retention compared to socioeconomically advantaged women. This study examines the effect of gestational weight gain on body mass index (BMI) transitions 5 years after pregnancy in socioeconomically disadvantaged women. Methods: Gestational weight gain was assessed in 2136 postpartum women participating in the Fragile Families and Child Well-being study who experienced full-term, singleton gestations. Longitudinal BMI transitions were defined as a change or stability in BMI category between two time points: BMI before the index pregnancy and BMI 5 years after the index pregnancy. Logistic regression models estimated the association between gestational weight gain and longitudinal BMI transitions, controlling for health before the index pregnancy, pregnancy history, and sociodemographic characteristics. Results: Excessive gestational weight gain was related to transitioning to a higher BMI category 5 years after the index pregnancy. Compared to white women, black and Hispanic women were more likely to transition or maintain a higher BMI category. Pregnancy history (i.e., parity at index pregnancy, interim pregnancy) and public assistance participation were associated with transitioning to a higher BMI category. Conclusions: Among socioeconomically disadvantaged women, excessive gestational weight gain is related to transitioning to, but not maintaining, a higher weight category 5 years after the index pregnancy. Black and Hispanic women who are also socioeconomically disadvantaged and overweight or obese before conception may benefit from preconception or postpartum counseling about the long-term effect of gaining excessive weight during pregnancy and in the years immediately after childbirth.

African American and White women׳s perceptions of weight gain, physical activity, and nutrition during pregnancy

“…Excessive gestational weight gain is associated with many adverse health outcomes, including an increased risk of gestational diabetes, preeclampsia, cesarean delivery, macrosomia, and overweight or obesity in the mother (Guelinckx et al, 2008; Hernandez, 2012; Nehring et al, 2011). Evidence also suggests an association between excessive gestational weight gain and future overweight and obesity in the offspring (Lau et al, 2014).…”

Pregnant women’s perceptions of weight gain, physical activity, and nutrition using Theory of Planned Behavior constructs

“…Only one-third of women meet the Institute of Medicine (IOM) weight gain guidelines during pregnancy, with up to 50 % gaining excessive weight (Institute of Medicine, 2007; Olson, 2008; Simas et al, 2011). Pregnancy weight gain above recommendations is associated with many adverse health outcomes, including an increased risk of gestational diabetes, preeclampsia, cesarean delivery, macrosomia, and new or persistent overweight or obesity in the mother (Guelinckx et al, 2008; Hernandez, 2012; Nehring et al, 2011). Evidence also suggests an association between excessive gestational weight gain and overweight and obesity in the offspring (Lau et al, 2014).…”

Potential for a Stress Reduction Intervention to Promote Healthy Gestational Weight Gain: Focus Groups with Low-Income Pregnant Women

“…Excessive GWG confers risk to the pregnant woman and her fetus. Maternal complications include increased risk of gestational diabetes mellitus (GDM), pre-eclampsia, Cesarean section, maternal mortality (Mamun, Callaway et al 2011; Norman and Reynolds 2011), and post-partum weight retention (Mamun, Kinarivala et al 2010; Nehring, Schmoll et al 2011; Hernandez 2012). For offspring, associated risks include increased rates of obesity in childhood and adulthood (Mamun, O'Callaghan et al 2009; Schack-Nielsen, Michaelsen et al 2010), greater potential for developing metabolic syndrome (Boney, Verma et al 2005), and increased incidence of autism spectrum disorders (O'Higgins, Doolan et al 2013).…”