Patterns of Weight Change One Year after Delivery Are Associated with Cardiometabolic Risk Factors at Six Years Postpartum in Mexican Women

Soria-Contreras, Diana C.; Trejo-Valdivia, Belém; Cantoral, Alejandra; Pizano-Zárate, María Luisa; Baccarelli, Andrea A.; Just, Allan C.; Colicino, Elena; Deierlein, Andrea; Wright, Robert O.; Oken, Emily; Téllez-Rojo, Martha M.; López‐Ridaura, Ruy

doi:10.3390/nu12010170

Cited by 18 publications

(20 citation statements)

References 53 publications

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“…Ideally, this should include an interdisciplinary approach to address weight management, an important part of CVD risk management. Studies show that postpartum weight retention and changes impact cardiometabolic risk in diverse populations [18,19]. Common themes that emerged from prior studies were a need for cost-effective longitudinal intervention, identifying barriers to healthcare attendance, and developing proactive strategies to promote participation [20,21].…”

Section: Discussionmentioning

confidence: 99%

Missed opportunities to prevent cardiovascular disease in women with prior preeclampsia

et al. 2020

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Background Cardiovascular disease (CVD) is the leading cause of death in women in every major developed country and in most emerging nations. Complications of pregnancy, including preeclampsia, indicate a subsequent increase in cardiovascular risk. There may be a primary care provider knowledge gap regarding preeclampsia as a risk factor for CVD. The objective of our study is to determine how often internists at an academic institution inquire about a history of preeclampsia, as compared to a history of smoking, hypertension and diabetes, when assessing CVD risk factors at well-woman visits. Additional aims were (1) to educate internal medicine primary care providers on the significance of preeclampsia as a risk factor for CVD disease and (2) to assess the impact of education interventions on obstetric history documentation and screening for CVD in women with prior preeclampsia. Methods A retrospective chart review was performed to identify women ages 18–48 with at least one prior obstetric delivery. We evaluated the frequency of documentation of preeclampsia compared to traditional risk factors for CVD (smoking, diabetes, and chronic hypertension) by reviewing the well-woman visit notes, past medical history, obstetric history, and the problem list in the electronic medical record. For intervention, educational teaching sessions (presentation with Q&A session) and education slide presentations were given to internal medicine physicians at clinic sites. Changes in documentation were evaluated post-intervention. Results When assessment of relevant pregnancy history was obtained, 23.6% of women were asked about a history preeclampsia while 98.9% were asked about diabetes or smoking and 100% were asked about chronic hypertension (p < 0.001). Education interventions did not significantly change rates of screening documentation (p = 0.36). Conclusion Our study adds to the growing body of literature that women with a history of preeclampsia might not be identified as having increased CVD risk in the outpatient primary care setting. Novel educational programming may be required to increase provider documentation of preeclampsia history in screening.

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Section: Discussionmentioning

confidence: 99%

Missed opportunities to prevent cardiovascular disease in women with prior preeclampsia

et al. 2020

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“…Excess postpartum weight retention has been linked to long-term maternal-infant outcomes, including metabolism changes in mothers, difficulties in breastfeeding initiation, and infant's microbiome [8]. Women who did not return to their pre-pregnancy weight and gained weight through one-year postpartum are at increased risk of obesity, insulin resistance, and metabolic syndrome at six-year postpartum [9]. Common risk factors of postpartum weight retention are related to pre-pregnancy and pregnancy periods, including pre-pregnancy BMI, gestational weight gain, and parity [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Postpartum Physical Activity and Weight Retention within One Year: A Prospective Cohort Study in Vietnam

Zhao

Binns

et al. 2020

IJERPH

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After delivery, mothers are encouraged to increase physical activity (PA) gradually to regulate body weight; however, data on PA in relation to postpartum weight retention remains scarce, particularly among Asian women. In a cohort of 1617 Vietnamese mothers, we investigated the prospective association between habitual PA exposures at 3-month postpartum and weight retention at 6-month and 12-month postpartum. Detailed information on PA intensity and domains was collected from participants using a validated instrument specifically for Vietnamese women. Linear regression analyses and a general linear model for the repeated weight retention measures were used to ascertain the apparent relationships. On average, the participants reported 3.6 (SD 3.9) and 2.6 (SD 3.8) kg weight loss at 6-and 12-month postpartum, respectively. Total and light-intensity PA were inversely associated with the postpartum weight retention (p for trend <0.05). Our findings highlight the importance of resuming PA in the early postpartum period as an appropriate weight management strategy.

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“…In a previous study, we found that women with PPWR, PPWG and PPWR þ WG, compared with those who returned to their pregestational weight by 1 year postpartum, had increased adiposity 6 years after delivery. We also found that PPWR þ WG was associated with metabolic alterations such as insulin resistance (13) . In the current study, we extend these results by identifying the contribution of specific modifiable factors to the risk of each of the patterns of weight change.…”

Section: Discussionmentioning

confidence: 52%

“…retention of gestational weight, followed by postpartum weight gain) (6,11,12) . We recently showed that PPWR, PPWG and PPWR þ WG were associated with increased adiposity at 6 years postpartum (13) . PPWR þ WG was the only pattern directly associated with metabolic markers, such as insulin resistance (13) .…”

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confidence: 96%

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Predictors of patterns of weight change 1 year after delivery in a cohort of Mexican women

Soria-Contreras

Téllez‐Rojo

Cantoral

et al. 2020

Public Health Nutr.

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Objective: To evaluate the associations of pregestational BMI, gestational weight gain (GWG) and breast-feeding at 1 month postpartum with four patterns of weight change during the first year after delivery: postpartum weight retention (PPWR), postpartum weight gain (PPWG), postpartum weight retention + gain (PPWR + WG) and return to pregestational weight. Design: In this secondary analysis of a prospective study, we categorised postpartum weight change into four patterns using pregestational weight and weights at 1, 6 and 12 months postpartum. We evaluated their associations with pregestational BMI, GWG and breast-feeding using multinomial logistic regression. Results are presented as relative risk ratios (RRR) and 95 % CI. Setting: Mexico City. Participants: Women participating in the Programming Research in Obesity, Growth, Environment and Social Stressors pregnancy cohort. Results: Five hundred women were included (53 % of the cohort). Most women returned to their pregestational weight by 1 year postpartum (57 %); 8 % experienced PPWR, 14 % PPWG and 21 % PPWR + WG. Compared with normal weight, pregestational overweight (RRR 2·5, 95 % CI 1·3, 4·8) and obesity (RRR 2·2, 95 % CI 1·0, 4·7) were associated with a higher risk of PPWG. Exclusive breast-feeding, compared with no breast-feeding, was associated with a lower risk of PPWR (RRR 0·3, 95 % CI 0·1, 0·9). Excessive GWG, compared with adequate, was associated with a higher risk of PPWR (RRR 3·3, 95 % CI 1·6, 6·9) and PPWR + WG (RRR 2·4, 95 % CI 1·4, 4·2). Conclusions: Targeting women with pregestational overweight or obesity and excessive GWG, as well as promoting breast-feeding, may impact the pattern of weight change after delivery and long-term women’s health.

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Patterns of Weight Change One Year after Delivery Are Associated with Cardiometabolic Risk Factors at Six Years Postpartum in Mexican Women

Cited by 18 publications

References 53 publications

Missed opportunities to prevent cardiovascular disease in women with prior preeclampsia

Missed opportunities to prevent cardiovascular disease in women with prior preeclampsia

Postpartum Physical Activity and Weight Retention within One Year: A Prospective Cohort Study in Vietnam

Predictors of patterns of weight change 1 year after delivery in a cohort of Mexican women

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