Socioeconomic disparities in prepregnancy BMI and impact on maternal and neonatal outcomes and postpartum weight retention: the EFHL longitudinal birth cohort study

Abstract

BackgroundLong-term obesity after pregnancy is associated with obesity prior to pregnancy and retention of weight postpartum. This study aims to identify socioeconomic differences in prepregnancy body mass index, quantify the impact of prepregnancy obesity on birth outcomes, and identify determinants of postpartum weight retention.MethodsA total of 2231 pregnant women, recruited from three public hospitals in Southeast Queensland in Australia during antenatal clinic visits, completed a questionnaire to elicit information on demographics, socioeconomic and behavioural characteristics. Perinatal information was extracted from hospital records. A follow-up questionnaire was completed by each participant at 12 months after the birth to obtain the mother’s postpartum weight, breastfeeding pattern, dietary and physical activity characteristics, and the child’s health and development information. Multivariate logistic regression method was used to model the association between prepregnancy obesity and outcomes.ResultsBeing overweight or obese prepregnancy was strongly associated with socioeconomic status and adverse behavioural factors. Obese women (18% of the cohort) were more likely to experience gestational diabetes, preeclampsia, cesarean delivery, and their children were more likely to experience intensive- or special-care nursery admission, fetal distress, resuscitation, and macrosomia. Women were more likely to retain weight postpartum if they consumed three or fewer serves of fruit/vegetables per day, did not engage in recreational activity with their baby, spent less than once a week on walking for 30 minutes or more or spent time with friends less than once per week. Mothers who breastfed for more than 3 months had reduced likelihood of high postpartum weight retention.ConclusionsFindings provide additional specificity to the increasing evidence of the predisposition of obesity prepregnancy on adverse maternal and perinatal outcomes. They may be used to target effective behavioural change interventions to address obesity in women.

The association between psychological factors and breastfeeding behaviour in women with a body mass index (BMI) ≥30 kg m−2: a systematic review

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Maternal and fetal outcomes of obese pregnant women: a prospective cohort study

“…Similar findings of prolonged labour was reported in previous studies. 21,[29][30][31] The mean (SD) birth weight was found to be higher in cases when compared to controls (3.2 (±0.86) vs 2.9 (±0.28)) (p = 0.07). Other studies have found out similar higher incidence of macrosomia.…”

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

“…Estudos prévios demonstraram múltiplos fatores associados à retenção de peso pós-parto (RPPP). Dentre eles, destacam-se o elevado ganho de peso gestacional (GPG) 7,8,9 , a menor idade 10,11 , a primiparidade 12,13 , o menor intervalo interpartal 14 , a pouca prática de atividade física 15 e a menor duração de aleitamento materno 15,16 . Entre os fatores citados, o GPG tem sido identificado como um dos principais determinantes.…”