Diana Cristina Soria-Contreras1, Martha María Téllez-Rojo1, Alejandra Cantoral1,2, María Luisa Pizano-Zárate3, Emily Oken4, Andrea A Baccarelli5, Allan C Just6, Manuela A Orjuela7, Ivonne Ramírez-Silva1, Robert O Wright6, Belem Trejo-Valdivia1, Ruy López-Ridaura8. 1. Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico. 2. National Council on Science and Technology, Mexico City, Mexico. 3. Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico. 4. Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. 5. Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA. 6. Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 7. Departments of Epidemiology, Mailman School of Public Health, and Pediatrics, Columbia University Medical Center, New York, NY, USA. 8. Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
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.
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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