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

Abstract

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.

How does gestational weight gain influence short‐ and long‐term postpartum weight retention? An updated systematic review and meta‐analysis

“…Nineteen countries were represented. Fourteen studies took place in North America, [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] six in Europe, [44][45][46][47][48][49][50][51] four in Australia, [52][53][54][55] seven in East/ Southeast Asia, 27,[56][57][58][59][60][61] one in Turkey, 28 1 in Lebanon/Qatar, 62 and one in Brazil. 63 The mean age of participants ranged from 23.8 to 33.3 years.…”

“…29,33,35,42,46,51 Socioeconomic status (SES) of women varied across studies. Six studies comprised predominantly women with low SES, defined as low educational attainment and/or low income, 30,32,33,40,41,56 whereas two studies reported that about half of the women in their cohort had low SES status. 29,37 Only primiparous women were recruited for four studies, 27,31,34,36,43 whereas one study recruited only multiparous women.…”

“…Maternal weight was measured by hospital or research staff and used to calculate GWG in 13 studies. 31,33,35,39,41,42,45,48,55,[57][58][59][60] Six studies obtained weight from medical records, 34,36,38,40,61,62 one from a national database, 29 and 13 studies relied on self-reported late pregnancy weight. 27,28,30,37,44,46,47,[49][50][51][52][53][54]56,63 One study obtained weights from both birth records and self-report and conducted analyses on both values for comparison.…”

“…Postpartum weight was measured by trained staff in 18 studies, 27,30,31,33,35,[40][41][42]45,47,48,[55][56][57][58][61][62][63] self-reported in 14 studies 28,32,34,[36][37][38]44,46,[49][50][51][52][53][54]59,60 and obtained from national records in one study. 29 One study instructed women to weigh themselves with a home scale that directly transmitted the data to the research center.…”

Breastfeeding, socioeconomic status, and long-term postpartum weight retention

“…Breastfeeding confers many benefits to not only the child but the mother as well [ 9 , 10 ], such as reduced risk of type 2 diabetes, certain breast cancers, and ovarian cancer [ 11 , 12 ]. Recent research has examined breastfeeding’s association with postpartum weight retention with breastfeeding characterized in various ways including duration (months or weeks) or ever breastfeeding [ 13 , 14 ]. However, it is unknown whether effects of breastfeeding duration on weight retention and long-term body size vary by socioeconomic status (SES).…”