The impact of psychosocial stressors on postpartum weight retention

Abstract Background High risk of bias associated with missing outcome data (MOD) in meta-analyses (MAs) of the effects of lifestyle interventions during pregnancy on postpartum weight retention (PPWR), casts doubt on whether such interventions can be relied upon as truly effective, since estimates are deemed valid only if MOD was missing at random (MAR). Methods We conducted a systematic overview of MAs to examine the impact of MOD on the estimation of meta-analytic summary intervention effects and conducted sensitivity analyses using pattern mixture models and informative missingness parameters (describing how the outcome in the missing participants may be related to the outcome in the completers), to ascertain the robustness of the estimates to reasonable deviations from the MAR assumption. Results Three relevant MAs were identified, all with high MOD rates in the RCTs included (median>30%), and all reporting beneficial intervention effects on PPWR (in kg) estimated based on complete case analyses: [-0.78 (95%CI: -1.39,-0.16), -0.81 (-1.57,-0.06), and -0.94 (-1.52,-0.37)] in MAs of any lifestyle, exercise, or diet + exercise interventions, respectively. In plausible scenarios where the outcome for the intervention group in participants with vs without MOD was worse (by 0.5kg), effect estimates were attenuated in all and no longer significant in 2 of the MAs [-0.58 (-1.29,0.13), -0.70 (-1.50,0.10) and -0.88 (-1.73,-0.02)]. Conclusions Statistical significance was retained when all 19 RCTs identified across MAs were meta-analysed: -0.63 (-0.17,-0.08). Key messages The clinical relevancy of effects of this magnitude remains unclear.

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The impact of sleep, stress, and depression on postpartum weight retention: A systematic review

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2014.09.016 ◽

2014 ◽

Vol 77 (5) ◽

pp. 351-358 ◽

Cited By ~ 19

Author(s):

Rui S. Xiao ◽

Aimee R. Kroll-Desrosiers ◽

Robert J. Goldberg ◽

Sherry L. Pagoto ◽

Sharina D. Person ◽

...

Keyword(s):

Systematic Review ◽

Postpartum Weight Retention ◽

Weight Retention ◽

Postpartum Weight ◽

The Impact

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The Impact of a Lifestyle Intervention on Postpartum Weight Retention Among At-Risk Hispanic Women

American Journal of Preventive Medicine ◽

10.1016/j.amepre.2021.02.005 ◽

2021 ◽

Author(s):

Madhuri Palnati ◽

Bess H. Marcus ◽

Penelope Pekow ◽

Milagros C. Rosal ◽

JoAnn E. Manson ◽

...

Keyword(s):

At Risk ◽

Lifestyle Intervention ◽

Hispanic Women ◽

Postpartum Weight Retention ◽

Weight Retention ◽

Postpartum Weight ◽

The Impact

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Characterizing the Impact of Breastfeeding and Socioeconomic Status on Maternal Weight Change From Pregnancy to Ten Years Postpartum

Current Developments in Nutrition ◽

10.1093/cdn/nzab046_043 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 746-746

Author(s):

Saralyn Foster ◽

Christian Vazquez ◽

Catherine Cubbin ◽

Amy Nichols ◽

Rachel Rickman ◽

...

Keyword(s):

Socioeconomic Status ◽

The United States ◽

Self Report ◽

World Health ◽

Postpartum Weight Retention ◽

Weight Retention ◽

Prepregnancy Bmi ◽

Postpartum Weight ◽

The Impact

Abstract Objectives Breastfeeding is a potentially modifiable factor associated with less postpartum weight retention; however, in the United States women with lower socioeconomic status (SES) are less likely to initiate breastfeeding and, therefore, may be at higher risk for long-term weight retention. We sought to describe associations between duration of breastfeeding with postpartum weight retention and later BMI, and to determine whether associations varied by SES. Methods Maternal and infant data (n = 2144 dyads) are from the Geographic Research on Wellbeing survey (GROW), a follow-up study of California's annual statewide-representative Maternal and Infant Health Assessment. Pre-pregnancy BMI was obtained from self-report; at 4–10y postpartum, breastfeeding history and self-reported body weight were collected. Multivariable linear regression was used to examine associations between breastfeeding and long-term maternal body size. SES was calculated as a composite score of % federal poverty threshold plus education and was dichotomized. Results Overall, mean prepregnancy BMI was 24.9 kg/m,2 while long-term weight retention 4–10 y postpartum was 4.0 kg. The sample average breastfeeding duration was 8.5 months with 61% meeting the World Health Organization (WHO) recommendations for 6 months of breastfeeding. In adjusted models, compared to women who did not meet recommendations, women who met WHO recommendations had slightly lower long-term postpartum weight retention (b = −1.06 kg, CI: −1.93, −0.25, p = 0.01) and a small reduction in BMI (b = −0.4 kg/m,2 95% CI −0.74, −0.08; p = 0.02). Compared to higher SES women, fewer lower SES women ever breastfed (89% vs 74%, p < .0001) or met WHO recommendations (70% vs 51%, p < .0001). Lower SES women had higher prepregnancy BMI (25.9kg/m2 vs 23.5, p < .0001), and had greater long-term weight retention 4–10 y postpartum (5.68kg vs. 1.83, p < .0001). In SES stratified adjusted models, there were no differences in associations between breastfeeding with long-term weight retention or BMI. Conclusions Breastfeeding was associated with long term maternal postpartum weight status. Six months of breastfeeding was associated with lower long-term postpartum weight retention and lower BMI at 4–10 years postpartum, and effects did not vary by socioeconomic status. Funding Sources CDPH, UCSF.

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Low selenium intake is associated with postpartum weight retention in Chinese women and impaired physical development of their offspring

British Journal Of Nutrition ◽

10.1017/s0007114521000015 ◽

2021 ◽

pp. 1-12

Author(s):

Feng Han ◽

Yiqun Liu ◽

Xuehong Pang ◽

Qin Wang ◽

Liping Liu ◽

...

Keyword(s):

Nutritional Status ◽

Chinese Women ◽

Multinomial Logistic Regression ◽

Daily Intake ◽

Physical Development ◽

Postpartum Weight Retention ◽

Weight Retention ◽

Low Level ◽

Postpartum Weight ◽

The Impact

Abstract The aim of this study was to investigate the association between daily Se intake and postpartum weight retention (PPWR) among Chinese lactating women, and the impact of their Se nutritional status on infants’ physical development. Se contents in breast milk and plasma collected from 264 lactating Chinese women at the 42nd day postpartum were analysed with inductively coupled plasma MS. Daily Se intake was calculated based on plasma Se concentration. The dietary data of 24-h records on three consecutive days were collected. Infant growth status was evaluated with WHO standards by Z-scores. Linear regression analyses and multinomial logistic regression were conducted to examine the impact of Se disequilibrium (including other factors) on PPWR and growth of infants, respectively. The results indicated that: (1) the daily Se intake of the subjects was negatively associated with their PPWR (B = −0·002, 95 % CI − 0·003, 0·000, P = 0·039); (2) both insufficient Se daily intake (B = −0·001, OR 0·999, 95 % CI 0·998, 1·000, P = 0·014) and low level of Se in milk (B = −0·025, OR 0·975, 95 % CI 0·951, 0·999, P = 0·021) had potential associations with their infants’ wasting, and low level of Se in milk (B = −0·159, OR 0·853, 95 % CI 0·743, 0·980, P = 0·024) had a significant association with their infants’ overweight. In conclusion, the insufficient Se nutritional status of lactating Chinese women was first found as one possible influencing factor of their PPWR as well as low physical development of their offspring.

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Postpartum Weight Loss in Women with Class-III Obesity: Do They Lose What They Gain?

American Journal of Perinatology ◽

10.1055/s-0039-1695778 ◽

2019 ◽

Vol 37 (01) ◽

pp. 053-058 ◽

Cited By ~ 1

Author(s):

Anne M. Siegel ◽

Ann Tucker ◽

LaMani D. Adkins ◽

Courtney Mitchell ◽

Haywood L. Brown ◽

...

Keyword(s):

Weight Loss ◽

Morbidly Obese ◽

Postpartum Weight Retention ◽

Weight Retention ◽

Obese Women ◽

Class Iii ◽

Postpartum Visit ◽

Class Iii Obesity ◽

Postpartum Weight ◽

The Impact

Abstract Objective Excessive gestational weight gain (GWG) increases risk of postpartum weight retention in normal and overweight women but little is known about weight retention in morbidly obese women. We evaluated the impact of GWG on postpartum weight retention in women with class-III obesity. Study Design This is a retrospective cohort of pregnancies at a single institution from July 2013 to December 2017 complicated by body mass index (BMI) ≥ 40 at entry to care. Women were classified as GWG within (WITHIN), less than (LESS), or greater than (MORE) Institute of Medicine's (IOM) recommendations. Women were excluded for multiples, late prenatal care, preterm birth, fetal anomalies, intrauterine demise, weight loss, and missing data. Primary outcome was achievement of intake weight at the postpartum visit. Logistic regression was used to adjust for confounding factors. Results Among 338 women, 93 (28%) gained WITHIN, 129 (38%) LESS, and 144 (43%) MORE. Women in the MORE group were less likely to achieve their intake weight at the postpartum visit (adjusted odds ratio [AOR] = 0.09 95% confidence interval [CI]: 0.05–0.17, p < 0.01). Women gaining MORE were the only group who did not lose weight from intake to postpartum (Median weight change [LESS: −14 lbs (IQR: −20 to −7)] vs. [WITHIN: −7 lbs (IQR: −13 to −1)] vs. [MORE: 5 lbs (IQR: 0–15)]; p < 0.01). Conclusion Excessive GWG in women with class-III obesity is associated with postpartum weight retention.

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Modeling the Impact of Prepregnancy BMI, Physical Activity, and Energy Intake on Gestational Weight Gain, Infant Birth Weight, and Postpartum Weight Retention

Journal of Physical Activity and Health ◽

10.1123/jpah.9.7.1020 ◽

2012 ◽

Vol 9 (7) ◽

pp. 1020-1029 ◽

Cited By ~ 14

Author(s):

Amy E. Montpetit ◽

Hugues Plourde ◽

Tamara R. Cohen ◽

Kristine G. Koski

Keyword(s):

Physical Activity ◽

Energy Intake ◽

Postpartum Weight Retention ◽

Weight Retention ◽

Gestational Weight ◽

Prepregnancy Bmi ◽

Prepregnancy Weight ◽

Postpartum Weight ◽

Infant Birth ◽

The Impact

Background:A “fit pregnancy” requires balancing energy expenditure with energy intake (EI) to achieve appropriate gestational weight gains (GWG), healthy infant birth weights (IBW), and minimal postpartum weight retention (PPWR). Our objective was to develop an integrated conceptual framework to assess the contribution of prepregnancy weight (PP-BMI), EI, and physical activity (PA) as determinants of GWG, IBW, and PPWR.Methods:Pregnant women (n = 59) were recruited from prenatal classes. Energy intake was estimated using 3 24-hr diet recalls and PA using a validated PA questionnaire and a pedometer. Telephone interviews at 6-weeks postpartum assessed self-reported GWG, IBW, and PPWR. Hierarchical multiple regression analyses were used to explore the potential predictors of GWG, IBW, and PPWR.Results:Prepregnancy BMI was associated with GWG, and EI was associated with IBW; each model captured only 6%–18% of the variability. In contrast, PPWR was predicted by PP-BMI, GWG, and EI, which together explained 61% of its variability, whereas GWG alone explained 51% of the variability in PPWR.Conclusions:Modeling the relationship using hierarchical models suggests that PP-BMI, prepartum PA, and EI differentially impact GWG, IBW, and PPWR.

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Breast-feeding and postpartum weight retention: a systematic review and meta-analysis

Public Health Nutrition ◽

10.1017/s1368980015000828 ◽

2015 ◽

Vol 18 (18) ◽

pp. 3308-3316 ◽

Cited By ~ 20

Author(s):

Xiujie He ◽

Meng Zhu ◽

Chuanlai Hu ◽

Xingyong Tao ◽

Yingchun Li ◽

...

Keyword(s):

Systematic Review ◽

Publication Bias ◽

Breast Feeding ◽

Meta Analysis ◽

Linear Regression Method ◽

Postpartum Weight Retention ◽

Weight Retention ◽

Pregnancy And Postpartum ◽

Postpartum Weight ◽

The Impact

AbstractObjectiveWeight gained during pregnancy and postpartum weight retention might contribute to obesity in women of childbearing age. Whether breast-feeding (BF) may decrease postpartum weight retention (PPWR) is still controversial. The purpose of our systematic review and meta-analysis was to investigate the relationship between BF and PPWR.DesignThree databases were systematically reviewed and the reference lists of relevant articles were checked. Meta-analysis was performed to quantify the pooled standardized mean differences (SMD) of BF on PPWR by using a random-effect model. Heterogeneity was tested using the χ2 test and I2 statistics. Publication bias was estimated from Egger’s test (linear regression method) or Begg’s test (rank correlation method).ResultsAmong 349 search hits, eleven studies met the inclusion criteria for the meta-analysis. Seven studies were conducted in the USA, one in Brazil, one in France, one in Georgia and one in Croatia. Compared with formula-feeding, BF for 3 to ≤6 months seemed to have a negative influence on PPWR and if BF continued for >6 months had little or no influence on PPWR. In a subgroup meta-analysis, the results did not change substantially after the analysis had been classified by available confounding factors. There was no indication of a publication bias from the result of either Egger’s test or Begg’s test.ConclusionsAlthough the available evidence held belief that BF decreases PPWR, more robust studies are needed to reliably assess the impact of patterns and duration of BF on PPWR.

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