scholarly journals Reducing Postpartum Weight Retention: A Review of the Implementation Challenges of Postpartum Lifestyle Interventions

2021 ◽  
Vol 10 (9) ◽  
pp. 1891
Author(s):  
Maureen Makama ◽  
Helen Skouteris ◽  
Lisa J. Moran ◽  
Siew Lim
Keyword(s):  
Large Scale ◽  
Strong Predictor ◽  
Later Life ◽  
Individual Characteristics ◽  
Postpartum Women ◽  
Successful Implementation ◽  
Lifestyle Interventions ◽  
Postpartum Weight Retention ◽  
Weight Retention ◽  
Postpartum Weight

Postpartum weight retention (PPWR) is a strong predictor of obesity in later life with long term health consequences in women. Suboptimal lifestyle behaviours (e.g., diet and physical activity) contribute to PPWR. Postpartum lifestyle interventions are known to be efficacious in reducing PPWR; however, there are challenges to their successful implementation. To inform implementation, this narrative review provides an overview of the factors that contribute to PPWR, the efficacy of existing postpartum lifestyle interventions and key determinants of effective implementation using the Consolidated Framework for Implementation Research (CFIR) across intervention characteristics, implementation process, individual characteristics and outer and inner setting. We then suggest strategies to improve the translation of evidence into large-scale interventions that deliver on health impact in postpartum women. We have identified gaps that need to be addressed to advance postpartum lifestyle research, including the involvement of postpartum women and community members as key stakeholders for optimal reach and engagement, more complete reporting of intervention characteristics to optimize translation of evidence into practice, capacity building of health professionals and guidelines for postpartum lifestyle management.

scholarly journals Postpartum Patient Navigation and Postpartum Weight Retention

2019 ◽  
Vol 09 (03) ◽  
pp. e292-e297
Author(s):  
Michelle A. Kominiarek ◽  
Sydney Summerlin ◽  
Noelle G. Martinez ◽  
Lynn M. Yee
Keyword(s):  
Race And Ethnicity ◽  
Patient Navigation ◽  
Care Utilization ◽  
Postpartum Women ◽  
Program Participation ◽  
Postpartum Weight Retention ◽  
Weight Retention ◽  
Prepregnancy Weight ◽  
Navigation Program ◽  
Postpartum Weight

Abstract Objective This study aimed to evaluate postpartum weight retention (PPWR) among women who participated in a postpartum patient navigation (PN) program. Study Design English-speaking pregnant or postpartum women receiving publicly-funded prenatal care at a hospital-based clinic were invited to receive PN services through 12 weeks postpartum. Women were eligible for this analysis if height and weight values were available. Weights at 4 to 12 weeks and up to 12 months postpartum were compared in PN and non-PN historical-control groups and analyzed as mean PPWR (difference from prepregnancy weight) and categorically as PPWR > 5kg. Results Among the 311 women, 152 participated in the PN program and 159 were historical controls. There were no differences in age, race and ethnicity, prepregnancy body mass index (BMI), nulliparity, and preterm birth between the groups (p > 0.05). At 4 to 12 weeks postpartum, mean PPWR (4.0 ± 6.7 vs. 2.7 ± 6.3 kg, p = 0.06) and PPWR > 5 kg (61/144 [42%] vs. 50/145 [34%], p = 0.15) did not differ between groups. Similarly, up to 12 months postpartum, mean PPWR (4.5 ± 7.1 vs. 5.0 ± 7.5 kg, p = 0.59) and PPWR > 5 kg (22/50 [44%] vs. 30/57 [53%], p = 0.55) did not differ between groups. Conclusion Although PN is a promising intervention to improve women's health care utilization and other associated health outcomes, in this particular navigation program, participation was not associated with PPWR at 4 to 12 weeks and up to 12 months postpartum.

scholarly journals What type of weight loss program do postpartum women want? Treatment preferences of postpartum women in two community settings

2010 ◽  
Vol 8 (1) ◽  
pp. 22-31 ◽  
Author(s):  
Suzanne Phelan ◽  
Katelyn Smith ◽  
John-Mark Steele ◽  
Dawn Wilt ◽  
Sally Ames ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Control ◽  
Self Report ◽  
Treatment Modalities ◽  
Treatment Preferences ◽  
Postpartum Women ◽  
Postpartum Weight Retention ◽  
Weight Retention ◽  
Face To Face ◽  
Postpartum Weight

Approximately 25% of women experience major weight gain after pregnancy, retaining more than 4.5 kg. Preliminary efforts to promote postpartum weight loss have encountered some success, but little is known about the types of programs of greatest interest to postpartum women. The purpose of this study was to better understand the weight control needs and preferences of postpartum women in the Women, Infants and Children (WIC) Nutrition program (N = 100) and an Adult Education Parenting (AEP) program (N = 75). A self-report questionnaire was used to collect participants’ demographic and weight history information as well as participants’ degree of interest in various weight loss treatment modalities. Results indicated that, independent of weeks postpartum and breastfeeding status, women in both groups (WIC and AEO) experienced high postpartum weight retention, and greater weight retention was reported in WIC than AEP (7.6 ± 7.7 kg vs. 3.2 ± 6.9 kg, respectively; p = .0001). When asked about types of weight control treatments, women in both setting expressed greatest interest in weekly face-to-face group meetings, but 66.2% of AEP and 60.6% of WIC reported needing childcare to attend such meetings. Women in both settings reported interest in an Internet-based program, particularly one that integrated monthly face-to-face meetings. Future randomized controlled trials are needed to examine the efficacy of Internet-based treatment in reducing postpartum weight retention in diverse patient populations.

scholarly journals 1463Impact of missing outcome data in meta-analyses of lifestyle interventions during pregnancy to reduce postpartum-weight-retention

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Rebecca Harris ◽  
Marijka Batterham ◽  
Elizabeth Neale ◽  
Isabel Ferreira
Keyword(s):  
Outcome Data ◽  
Sensitivity Analyses ◽  
Lifestyle Interventions ◽  
Postpartum Weight Retention ◽  
Weight Retention ◽  
Intervention Effects ◽  
Exercise Interventions ◽  
Postpartum Weight ◽  
Meta Analyses ◽  
The Impact

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.

scholarly journals Lifestyle Interventions in Overweight and Obese Pregnant or Postpartum Women for Postpartum Weight Management: A Systematic Review of the Literature

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1704 ◽  
Author(s):  
Kathryn V. Dalrymple ◽  
Angela C. Flynn ◽  
Sophie A. Relph ◽  
Majella O’Keeffe ◽  
Lucilla Poston
Keyword(s):  
Systematic Review ◽  
Weight Management ◽  
Control Group ◽  
Postpartum Women ◽  
Lifestyle Interventions ◽  
Weight Retention ◽  
Excessive Gestational Weight Gain ◽  
Pregnancy And Postpartum ◽  
Postpartum Weight ◽  
Randomised Controlled

Excessive gestational weight gain (GWG) and postpartum weight retention (PPWR) may predispose women to the development of obesity. The objective of this systematic review was to evaluate the effectiveness of lifestyle interventions in overweight or obese pregnant and/or postpartum women for managing postpartum weight up to 2 years after giving birth. Eighteen randomised controlled trials were included (2559 participants) and divided into three categories according to the timing of the intervention: pregnancy only (n = 3), postpartum only (n = 12) and pregnancy and postpartum (n = 3). The intervention duration varied from 10 weeks to 10 months and included diet only (n = 5) or diet and physical activity (n = 13). Seven postpartum only interventions reported significant improvements in postpartum weight when compared to the control group. Most of these interventions were short and intensive, lasting 10–16 weeks. One pregnancy only and one pregnancy and postpartum intervention reported reduced PPWR at 6 months. Nine trials did not report an effect of the intervention on postpartum weight. However, of these, four reported associations between GWG and PPWR. This review suggests that successful postpartum weight management is achievable with intensive lifestyle interventions starting in the postpartum period; however, there is insufficient evidence to conclude whether interventions starting in pregnancy are effective. Larger trials utilising comparative methodologies in the pregnancy and postpartum periods are required to inform the development of targeted strategies preventing PPWR or reducing postpartum weight.

Sign in / Sign up

Export Citation Format

Share Document