Postpartum Weight Change in Relation to Pre-Pregnancy Weight and Gestational Weight Gain in Women in Low-Income Setting: Data from the KITE Cohort in the Northern Part of Ethiopia

(1) Background: Postpartum weight may increase compared to pre-pregnancy due to weight retention or decrease due to weight loss. Both changes could pose deleterious effects on maternal health and subsequent pregnancy outcomes. Therefore, this study aimed to assess postpartum weight change and its associated factors. (2) Methods: A total of 585 women from the KIlte-Awlaelo Tigray Ethiopia (KITE) cohort were included in the analysis. (3) Results: The mean pre-pregnancy body mass index and weight gain during pregnancy were 19.7 kg/m2 and 10.8 kg, respectively. At 18 to 24 months postpartum, the weight change ranged from −3.2 to 5.5 kg (mean = 0.42 kg [SD = 1.5]). In addition, 17.8% of women shifted to normal weight and 5.1% to underweight compared to the pre-pregnancy period. A unit increase in weight during pregnancy was associated with higher weight change (β = 0.56 kg, 95% CI [0.52, 0.60]) and increased probability to achieve normal weight (AOR = 1.65, 95% CI [1.37, 2.00]). Food insecurity (AOR = 5.26, 95% CI [1.68, 16.50]), however, was associated with a shift to underweight postpartum. Interestingly, high symptoms of distress (AOR = 0.13, 95% CI [0.03, 0.48]) also negatively impacted a change in weight category. (4) Conclusions: In low-income settings such as northern Ethiopia, higher weight gain and better mental health during pregnancy may help women achieve a better nutritional status after pregnancy and before a possible subsequent pregnancy.

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

Public Health Nutrition ◽

10.1017/s1368980020002803 ◽

2020 ◽

pp. 1-11

Author(s):

Diana Cristina Soria-Contreras ◽

Martha María Téllez-Rojo ◽

Alejandra Cantoral ◽

María Luisa Pizano-Zárate ◽

Emily Oken ◽

...

Keyword(s):

Weight Gain ◽

Breast Feeding ◽

Weight Change ◽

Multinomial Logistic Regression ◽

Secondary Analysis ◽

Normal Weight ◽

Postpartum Weight Retention ◽

Weight Retention ◽

Growth Environment ◽

Postpartum Weight

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.

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Limiting Excess Weight Gain in Healthy Pregnant Women: Importance of Energy Intakes, Physical Activity, and Adherence to Gestational Weight Gain Guidelines

Journal of Pregnancy ◽

10.1155/2013/787032 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 15

Author(s):

Tamara R. Cohen ◽

Kristine G. Koski

Keyword(s):

Physical Activity ◽

Weight Gain ◽

Gestational Weight Gain ◽

Normal Weight ◽

Weight Retention ◽

Gestational Weight ◽

Daily Energy ◽

Postpartum Weight ◽

Logistic Regressions ◽

Activity Questionnaire

Few studies have investigated if compliance with energy intakes, physical activity, and weight gain guidelines attenuate postpartum weight retention (PPWR) in mothers attending prenatal classes. We investigated whether (a) daily energy intakes within 300 kcal of estimated energy requirements (EERs), (b) walking more than 5000 steps/day, (c) targeting the recommended weight gain goals for prepregnancy BMI, and/or (d) achieving weekly or total gestational weight gain (GWG) recommendations minimized PPWR in 54 women attending prenatal classes in Montreal/Ottawa, Canada. Participants completed a validated pregnancy physical activity questionnaire (PPAQ), 3 telephone-validated 24-hr dietary recalls, and wore a pedometer for one week. PPWR was measured 6 weeks after delivery. Results showed that 72% had healthy prepregnancy BMIs. However, 52% consumed>300 kcal/day in excess of their EER, 54% exceeded recommended GWG, and more overweight (93%) than normal weight women (38%) cited nonrecommended GWG targets. Following delivery, 33% were classified as overweight, and 17% were obese. Multiple logistic regressions revealed that women targeting “recommended weight gain advice” were 3 times more likely to meet total GWG recommendations (OR: 3.2,P<0.05); women who complied with weekly GWG goals minimized PPWR (OR: 4.2,P<0.02). In conclusion, appropriate GWG targets, lower energy intakes, and physical activity should be emphasized in prenatal education programs.

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Maternal weight change from prepregnancy to 18 months postpartum and subsequent risk of hypertension and cardiovascular disease in Danish women: A cohort study

PLoS Medicine ◽

10.1371/journal.pmed.1003486 ◽

2021 ◽

Vol 18 (4) ◽

pp. e1003486

Author(s):

Helene Kirkegaard ◽

Mette Bliddal ◽

Henrik Støvring ◽

Kathleen M. Rasmussen ◽

Erica P. Gunderson ◽

...

Keyword(s):

Cardiovascular Disease ◽

Weight Loss ◽

Cohort Study ◽

Weight Gain ◽

Weight Change ◽

Postpartum Weight Retention ◽

Weight Retention ◽

Prepregnancy Bmi ◽

Postpartum Weight

Background One-fourth of women experience substantially higher weight years after childbirth. We examined weight change from prepregnancy to 18 months postpartum according to subsequent maternal risk of hypertension and cardiovascular disease (CVD). Methods and findings We conducted a cohort study of 47,966 women with a live-born singleton within the Danish National Birth Cohort (DNBC; 1997–2002). Interviews during pregnancy and 6 and 18 months postpartum provided information on height, gestational weight gain (GWG), postpartum weights, and maternal characteristics. Information on pregnancy complications, incident hypertension, and CVD was obtained from the National Patient Register. Using Cox regression, we estimated adjusted hazard ratios (HRs; 95% confidence interval [CI]) for hypertension and CVD through 16 years of follow-up. During this period, 2,011 women were diagnosed at the hospital with hypertension and 1,321 with CVD. The women were on average 32.3 years old (range 18.0–49.2) at start of follow-up, 73% had a prepregnancy BMI <25, and 27% a prepregnancy BMI ≥25. Compared with a stable weight (±1 BMI unit), weight gains from prepregnancy to 18 months postpartum of >1–2 and >2 BMI units were associated with 25% (10%–42%), P = 0.001 and 31% (14%–52%), P < 0.001 higher risks of hypertension, respectively. These risks were similar whether weight gain presented postpartum weight retention or a new gain from 6 months to 18 months postpartum and whether GWG was below, within, or above the recommendations. For CVD, findings differed according to prepregnancy BMI. In women with normal-/underweight, weight gain >2 BMI units and weight loss >1 BMI unit were associated with 48% (17%–87%), P = 0.001 and 28% (6%–55%), P = 0.01 higher risks of CVD, respectively. Further, weight loss >1 BMI unit combined with a GWG below recommended was associated with a 70% (24%–135%), P = 0.001 higher risk of CVD. No such increased risks were observed among women with overweight/obesity (interaction by prepregnancy BMI, P = 0.01, 0.03, and 0.03, respectively). The limitations of this observational study include potential confounding by prepregnancy metabolic health and self-reported maternal weights, which may lead to some misclassification. Conclusions Postpartum weight retention/new gain in all mothers and postpartum weight loss in mothers with normal-/underweight may be associated with later adverse cardiovascular health.

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Postpartum Weight-Loss Tracker to Guide Low-Income Postpartum Women on their Weight-Loss Journey

Californian Journal of Health Promotion ◽

10.32398/cjhp.v18i1.2454 ◽

2020 ◽

Vol 18 (1) ◽

pp. 53-59

Author(s):

Maria Koleilat ◽

Sarah Radcliffe ◽

Laura Kim ◽

Erin Frost ◽

Paul S. Inventado

Keyword(s):

Weight Loss ◽

Low Income ◽

Well Being ◽

Subsequent Pregnancy ◽

Weight Retention ◽

Women Studies ◽

Innovative Tool ◽

Postpartum Weight ◽

Willingness To Use ◽

Initial Impressions

Studies have shown that postpartum weight retention is a key contributor to obesity among women. Studies have also shown that resources dedicated to postpartum weight loss are scarce. Weight tracking has been found to help with weight management during pregnancy. However, a postpartum weight-loss tracker (PPWLT) was yet to exist. This article describes the creation and initial impressions of a PPWLT that were collected via focus groups (FG) discussions with WIC participants. Methods: Two FG discussions (English and Spanish) were conducted at a WIC clinic in Southern California. All discussions were audio-recorded for transcription. Transcripts were analyzed using the scissor –and-sort technique. The sample consisted of ten Latina women, with a mean age of 28.7 ± 5.06 years and a mean current Body Mass Index (BMI) of 32.8 ± 7.8. Results: Participants in both FGs expressed a strong interest in the PPWLT and reported a willingness to use the tracker if provided by WIC. The Spanish-speaking group had several specific suggestions to make the instructions easier to understand. Conclusion: We believe that this new innovative tool has the potential to impact a mother’s well-being and give her an opportunity to optimize her health before a subsequent pregnancy.

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Influence of prenatal perceived stress on postpartum weight retention is mediated by high gestational weight gain in women with overweight

Clinical Obesity ◽

10.1111/cob.12446 ◽

2021 ◽

Author(s):

Krista S. Leonard ◽

Elizabeth L. Adams ◽

Jennifer S. Savage ◽

Ian M. Paul ◽

Jennifer L. Kraschnewski ◽

...

Keyword(s):

Weight Gain ◽

Gestational Weight Gain ◽

Perceived Stress ◽

Postpartum Weight Retention ◽

Weight Retention ◽

Gestational Weight ◽

Postpartum Weight

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Excessive Weight Gain in Pregnancy and Postpartum Weight Retention: a Comprehensive View on the Topic

Clinics in Mother and Child Health ◽

10.4172/2090-7214.1000186 ◽

2015 ◽

Vol 12 (3) ◽

Author(s):

Margarida Moreira

Keyword(s):

Weight Gain ◽

Postpartum Weight Retention ◽

Weight Retention ◽

Excessive Weight Gain ◽

Comprehensive View ◽

Excessive Weight ◽

Pregnancy And Postpartum ◽

Postpartum Weight ◽

In Pregnancy

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3134 Organophosphate pesticide exposure during pregnancy, gestational weight gain and long-term postpartum weight retention

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.119 ◽

2019 ◽

Vol 3 (s1) ◽

pp. 50-50

Author(s):

Linda G Kahn ◽

Elise M Philips ◽

Michiel A van den Dries ◽

Romy Gaillard ◽

Susana Santos ◽

...

Keyword(s):

Weight Gain ◽

Pesticide Exposure ◽

Late Pregnancy ◽

Fold Increase ◽

Folic Acid Supplementation ◽

Weight Retention ◽

Obese Women ◽

Gestational Weight ◽

Pesticide Metabolites ◽

Postpartum Weight

OBJECTIVES/SPECIFIC AIMS: Little is known about potentially obesogenic endocrine-disruptors’ effects on excessive gestational weight gain (GWG) and postpartum weight retention (PPWR), which increase risk of adverse pregnancy and postnatal outcomes. We explored associations between prenatal organophosphate (OP) pesticide exposure and increased weight both during and after pregnancy. METHODS/STUDY POPULATION: Three dimethyl (DM) and three diethyl (DE) OP metabolites were measured in spot urine samples collected at <18, 18-25, and >25 gestational weeks among 688 participants in the Generation R Study. Metabolite levels were expressed as molar concentration/gram creatinine and log10-transformed. GWG and PPWR were calculated as the difference between weight at each prenatal/postnatal visit or maximum gestational weight and pre-pregnancy weight. In covariate-adjusted regression models we assessed associations of metabolite concentrations at each prenatal visit and, where appropriate, averaged across pregnancy with early-to-mid pregnancy, mid-to-late pregnancy, late pregnancy-to-maximum, and total GWG; insufficient and excessive GWG according to Institute of Medicine guidelines; and long-term PPWR at 6 and 10 years postpartum. Based on OP pesticides’ lipophilicity and association with hypomethylation, we investigated interactions with pre-pregnancy body mass index, periconceptional folic acid supplementation, and breastfeeding duration. RESULTS/ANTICIPATED RESULTS: A 10-fold increase in late pregnancy DE metabolite concentration was associated with 1.34 kg [95% confidence interval: 0.55, 2.12] higher late pregnancy-to-maximum GWG. A 10-fold increase in mean DE metabolite concentration across pregnancy was associated with 2.41 kg [0.62, 4.20] lower PPWR at 6 years. Stratified analysis suggested that the prenatal finding was driven by women with pre-pregnancy BMI ≥25 kg/m2, while the postnatal finding was driven by women with pre-pregnancy BMI <25 kg/m2 and with inadequate folic acid supplementation. We found no associations between OP pesticide metabolites and insufficient or excessive weight gain and no interaction with breastfeeding. DISCUSSION/SIGNIFICANCE OF IMPACT: In this longitudinal analysis, we observed a positive association of OP pesticide metabolites with GWG in late pregnancy among overweight/obese women, potentially reflecting inhibition of OP pesticide detoxification by oxidative stress. Postnatally, under/normal weight women with higher OP pesticide metabolites had lower PPWR, possibly due to better metabolic function and a more healthful diet. These results suggest that there may be a critical period during the late phase of pregnancy when OP pesticide exposure may increase GWG, and this association may be amplified in overweight/obese women. Areas for future research include examination of how the interaction between OP pesticides and polymorphisms of the paraoxonase (PON1) gene, which detoxifies OP pesticides, affect GWG/PPWR; exploration of the interplay among maternal pre-pregnancy BMI, oxidative stress, and PON1 levels; and characterization of the variability of OP pesticides exposure across pregnancy using more frequent repeated urine samples.

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