How do pregnancy-related weight changes and breastfeeding relate to maternal weight and BMI-adjusted waist circumference 7 y after delivery? Results from a path analysis

Abstract

<jats:title>ABSTRACT</jats:title> <jats:p>Background: Reproduction has been related to long-term maternal weight gain, and changes in fat mass, with gestational weight gain, have been identified as an important contributor. However, the influence of weight changes during the whole reproductive cycle and the modifying effect of breastfeeding are unknown.</jats:p> <jats:p>Objective: The objective was to examine how prepregnancy weight, gestational weight gain, postpartum weight changes, and breastfeeding influence maternal weight and body mass index–adjusted waist circumference (WCBMI) 7 y after delivery.</jats:p> <jats:p>Design: This was a prospective cohort study of 23,701 women participating in the Danish National Birth Cohort with singleton births and no births during follow-up. Path analysis was used to assess the total, direct, and indirect effects; the latter was mediated through weight changes on the pathways.</jats:p> <jats:p>Results: Postpartum weight retention at 6 mo and weight gain from 6 to 18 mo postpartum were highly positively associated with both outcomes. A 1-kg increase in weight retention at 6 mo postpartum corresponded to an average increase of 0.5 kg at 7 y. Gestational weight gain was not associated with WCBMI but was positively associated with weight at 7 y; 87% of this effect was mediated through later weight changes. For both outcomes, a small inverse association was observed for breastfeeding duration. This was strongest for WCBMI, for which 97% of the effect was direct, ie, not mediated through postpartum weight.</jats:p> <jats:p>Conclusions: These findings show that postpartum weight retention at 6 mo and weight gain from 6 to 18 mo postpartum contribute equally to adverse maternal anthropometric measures 7 y after delivery. Breastfeeding duration may have a beneficial effect.</jats:p>

Maternal weight change from prepregnancy to 7 years postpartum—the influence of behavioral factors

“…Within a 10-year period, childbearing women gain on average 2-3 kg more than nonchildbearing women (1). This gain is highly variable, however, as excessive weight retention (>5 kg) 1 year postpartum (2) and excessive weight gain (>5 kg) from prepregnancy to 7 years postpartum (3) have been observed in one of four women. The additional fat mass seems to accumulate at the abdomen (4), the most harmful location for fat storage, and maternal weight gain increases the risk of obesity, obesity-related diseases later in life (5), and complications in subsequent pregnancies (6).…”

“…Both excessive gestational weight gain and weight retention postpartum have been identified as risk factors for long-term maternal weight gain (3,5,7,8), but maternal behavior may also affect longterm weight gain. Smoking cessation, reduced breastfeeding, less physical activity, more sedentary activity, intake of junk or fried food, and high food intake postpartum have been associated with excessive gestational weight gain or postpartum weight retention within the first 2 years after delivery (9)(10)(11)(12)(13)(14)(15).…”

Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women's Health Initiative

“…Women who report more than 9 cumulative months of breastfeeding over their reproductive lifetime are less likely to develop hypertension, hyperlipidemia, and metabolic syndrome 32, 33, 34, 35, 36, 37. Further, evidence suggests that a longer duration of breastfeeding is associated with a lower risk of developing type 2 diabetes mellitus,38, 39, 40, 41, 42, 43 and reduced maternal postpartum weight 44, 45, 46, 47…”

Efeitos do ganho de peso gestacional e do aleitamento materno na retenção de peso pós-parto em mulheres da coorte BRISA

“…O aleitamento materno também pode contribuir para as alterações no peso e distribuição de gordura das mães 18,19 . As pesquisas apontam uma potencial contribuição do aleitamento materno na redução da RPPP, por meio do aumento do gasto energético 20 ou da regulação do metabolismo e do apetite durante a lactação 21 .…”