Association between weight gain during pregnancy and postpartum weight retention and obesity: a bias-adjusted meta-analysis

Prospective studies examining postpartum weight retention (PPWR) in relation to the appropriateness of gestational weight gain (GWG) and leisure-time physical activity (LTPA) during pregnancy and postpartum are lacking. While utilizing varying estimates of prepregnancy weight, we sought to prospectively examine associations among the aforementioned variables. Our sample consisted of a subset of women from the Archive for Research on Child Health Study (n = 68). Prepregnancy weight was obtained via questionnaire and birth certificates. GWG (2 estimates) was calculated by subtracting prepregnancy weight estimates from weight at delivery and classified as “excess” or “not excess.” Pregnancy and postpartum LTPA were self-reported and dichotomized at recommended levels. Prepregnancy weight estimates were subtracted from self-reported postpartum weight to calculate 2 estimates of PPWR at 6 months. Linear regression was used to examine relationships among GWG and LTPA, and PPWR. Estimates of excess GWG were associated with increased PPWR (mean difference = 3.3-8.9 kg), even after adjustment for prepregnancy body mass index and breastfeeding. Meeting pregnancy and postpartum LTPA recommendations did not significantly predict PPWR. Our findings highlight the importance of encouraging appropriate GWG and provide insight into the impact varying estimates of prepregnancy weight may have when exploring associations among these variables.

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Pre-pregnancy BMI, gestational weight gain and postpartum weight retention: a meta-analysis of observational studies

Public Health Nutrition ◽

10.1017/s1368980014002523 ◽

2014 ◽

Vol 18 (12) ◽

pp. 2172-2182 ◽

Cited By ~ 72

Author(s):

Ke Rong ◽

Kai Yu ◽

Xiaolong Han ◽

Ignatius MY Szeto ◽

Xueying Qin ◽

...

Keyword(s):

Weight Gain ◽

Gestational Weight Gain ◽

Meta Analysis ◽

Postpartum Weight Retention ◽

Weight Retention ◽

Eligibility Criteria ◽

Gestational Weight ◽

Early Postpartum ◽

Postpartum Weight ◽

Science Citation Index Expanded

AbstractObjectiveTo determine the association of gestational weight gain (GWG) or pre-pregnancy BMI with postpartum weight retention (PPWR).DesignMeta-analysis.SettingPubMed, Cochrane Controlled Trials Register, EMBASE, Science Citation Index Expanded, Current Contents Connects and Biosis Previews were used to search articles.SubjectsPublications that described the influence of pre-pregnancy BMI or GWG on PPWR.ResultsSeventeen studies that satisfied the eligibility criteria were included in the analyses. Women with inadequate and excessive GWG had significantly lower mean PPWR of −2·14 kg (95 % CI –2·43, –1·85 kg) and higher PPWR of 3·21 kg (95 % CI 2·79, 3·62 kg), respectively, than women with adequate GWG. When postpartum time spans were stratified into 1–3 months, 3–6 months, 6–12 months, 12–36 months and ≥15 years, the association between inadequate GWG and PPWR faded over time and became insignificant (−1·42 kg; 95 % CI −3·08, 0·24 kg) after ≥15 years. However, PPWR in women with excess GWG exhibited a U-shaped trend; that is, a decline during the early postpartum time span (year 1) and then an increase in the following period. Meta-analysis of qualitative studies showed a significant relationship between excessive GWG and higher PPWR risk (OR=2·08; 95 % CI 1·60, 2·70). Moreover, meta-analysis of pre-pregnancy BMI on PPWR indicated that mean PPWR decreased with increasing BMI group.ConclusionsThese findings suggest that GWG, rather than pre-pregnancy BMI, determines the shorter- or longer-term PPWR.

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Effectiveness of exercise interventions in the prevention of excessive gestational weight gain and postpartum weight retention: a systematic review and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-099399 ◽

2018 ◽

Vol 52 (21) ◽

pp. 1347-1356 ◽

Cited By ~ 39

Author(s):

Stephanie-May Ruchat ◽

Michelle F Mottola ◽

Rachel J Skow ◽

Taniya S Nagpal ◽

Victoria L Meah ◽

...

Keyword(s):

Systematic Review ◽

Weight Gain ◽

Meta Analysis ◽

Postpartum Weight Retention ◽

Weight Retention ◽

Gestational Weight ◽

Postpartum Weight ◽

Type Of Exercise ◽

Prenatal Exercise ◽

Quality Evidence

ObjectiveGestational weight gain (GWG) has been identified as a critical modifier of maternal and fetal health. This systematic review and meta-analysis aimed to examine the relationship between prenatal exercise, GWG and postpartum weight retention (PPWR).DesignSystematic review with random effects meta-analysis and meta-regression. Online databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs in English, Spanish or French were eligible (except case studies and reviews) if they contained information on the population (pregnant women without contraindication to exercise), intervention (frequency, intensity, duration, volume or type of exercise, alone [“exercise-only”] or in combination with other intervention components [eg, dietary; “exercise + co-intervention”]), comparator (no exercise or different frequency, intensity, duration, volume or type of exercise) and outcomes (GWG, excessive GWG (EGWG), inadequate GWG (IGWG) or PPWR).ResultsEighty-four unique studies (n=21 530) were included. ‘Low’ to ‘moderate’ quality evidence from randomised controlled trials (RCTs) showed that exercise-only interventions decreased total GWG (n=5819; −0.9 kg, 95% CI −1.23 to –0.57 kg, I2=52%) and PPWR (n=420; −0.92 kg, 95% CI −1.84 to 0.00 kg, I2=0%) and reduced the odds of EGWG (n=3519; OR 0.68, 95% CI 0.57 to 0.80, I2=12%) compared with no exercise. ‘High’ quality evidence indicated higher odds of IGWG with prenatal exercise-only (n=1628; OR 1.32, 95% CI 1.04 to 1.67, I2=0%) compared with no exercise.ConclusionsPrenatal exercise reduced the odds of EGWG and PPWR but increased the risk of IGWG. However, the latter result should be interpreted with caution because it was based on a limited number of studies (five RCTs).

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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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