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Modifiable risk factors of maternal postpartum weight retention: an analysis of their combined impact and potential opportunities for prevention

Modifiable risk factors of maternal postpartum weight retention: an analysis of their combined impact and potential opportunities for prevention
Modifiable risk factors of maternal postpartum weight retention: an analysis of their combined impact and potential opportunities for prevention
Background/Objectives:Pregnancy triggers a physiological change in weight status. Postpartum weight retention in the childbearing years can substantially alter a woman’s weight gain trajectory, with several potential contributing factors identified. Most research has relied on women’s recall of pre-pregnancy weight during pregnancy or later, and not considered risk factors in combination. Using measured pre-pregnancy weight, this study aimed to examine the associations of maternal postpartum weight retention with parity, pre-pregnancy BMI, excessive gestational weight gain (GWG), maternal serum vitamin D concentration and dietary Glycaemic Index in early and late pregnancy, and breastfeeding duration, including analysis of the combined impact of potentially modifiable risk factors.
Subjects/Methods:Prospective cohort study of 12 583 non-pregnant women aged 20–34 years in Southampton (UK) who were assessed prior to pregnancy, with those who subsequently became pregnant followed up in early and late gestation, and after delivery (n=2559 in the final sample). Linear regression models examined potential predictors of weight retention in adjusted individual and multivariate analyses, and as a risk factor score.
Results:Compared with pre-pregnancy weight, 73% of women retained some weight at 6 months postpartum (mean (s.d.): 3.5 (6.2) kg). In the adjusted multivariate model, women who were primiparous, had a lower pre-pregnancy BMI, excessive GWG, a lower early pregnancy vitamin D concentration and breastfed for <6 months had greater weight retention 6 months postpartum (P<0.05 for all variables). For each additional modifiable risk factor (excessive GWG, low vitamin D concentration in early pregnancy and short breastfeeding duration; scale 0–3), women retained an additional 2.49 kg (95% CI: 2.16, 2.82; P<0.001).
Conclusions:Having a greater number of modifiable risk factors was associated with greater weight retention 6 months postpartum. Initiatives supporting women to target these risk factors in the years prior to, during and after pregnancy could impact on their weight gain trajectory and later risk of adverse weight-related outcomes.
0307-0565
1091–1098
Hollis, J. L.
ef34860b-a2fc-43c9-afca-a9d9b41fc0b0
Crozier, S. R.
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Inskip, H. M.
5fb4470a-9379-49b2-a533-9da8e61058b7
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Godfrey, K. M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Harvey, N. C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Collins, C. E.
b3644bdf-fadc-4563-8ceb-900ad4c57b98
Robinson, S. M.
ba591c98-4380-456a-be8a-c452f992b69b
Southampton Women's Survey Study Group
Hollis, J. L.
ef34860b-a2fc-43c9-afca-a9d9b41fc0b0
Crozier, S. R.
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Inskip, H. M.
5fb4470a-9379-49b2-a533-9da8e61058b7
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Godfrey, K. M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Harvey, N. C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Collins, C. E.
b3644bdf-fadc-4563-8ceb-900ad4c57b98
Robinson, S. M.
ba591c98-4380-456a-be8a-c452f992b69b

Hollis, J. L., Crozier, S. R., Inskip, H. M., Cooper, C., Godfrey, K. M., Harvey, N. C., Collins, C. E. and Robinson, S. M. , Southampton Women's Survey Study Group (2017) Modifiable risk factors of maternal postpartum weight retention: an analysis of their combined impact and potential opportunities for prevention. International Journal of Obesity, 41 (7), 1091–1098. (doi:10.1038/ijo.2017.78).

Record type: Article

Abstract

Background/Objectives:Pregnancy triggers a physiological change in weight status. Postpartum weight retention in the childbearing years can substantially alter a woman’s weight gain trajectory, with several potential contributing factors identified. Most research has relied on women’s recall of pre-pregnancy weight during pregnancy or later, and not considered risk factors in combination. Using measured pre-pregnancy weight, this study aimed to examine the associations of maternal postpartum weight retention with parity, pre-pregnancy BMI, excessive gestational weight gain (GWG), maternal serum vitamin D concentration and dietary Glycaemic Index in early and late pregnancy, and breastfeeding duration, including analysis of the combined impact of potentially modifiable risk factors.
Subjects/Methods:Prospective cohort study of 12 583 non-pregnant women aged 20–34 years in Southampton (UK) who were assessed prior to pregnancy, with those who subsequently became pregnant followed up in early and late gestation, and after delivery (n=2559 in the final sample). Linear regression models examined potential predictors of weight retention in adjusted individual and multivariate analyses, and as a risk factor score.
Results:Compared with pre-pregnancy weight, 73% of women retained some weight at 6 months postpartum (mean (s.d.): 3.5 (6.2) kg). In the adjusted multivariate model, women who were primiparous, had a lower pre-pregnancy BMI, excessive GWG, a lower early pregnancy vitamin D concentration and breastfed for <6 months had greater weight retention 6 months postpartum (P<0.05 for all variables). For each additional modifiable risk factor (excessive GWG, low vitamin D concentration in early pregnancy and short breastfeeding duration; scale 0–3), women retained an additional 2.49 kg (95% CI: 2.16, 2.82; P<0.001).
Conclusions:Having a greater number of modifiable risk factors was associated with greater weight retention 6 months postpartum. Initiatives supporting women to target these risk factors in the years prior to, during and after pregnancy could impact on their weight gain trajectory and later risk of adverse weight-related outcomes.

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Accepted/In Press date: 15 March 2017
e-pub ahead of print date: 24 March 2017
Published date: July 2017
Organisations: Medical Research Council, Human Development & Health

Identifiers

Local EPrints ID: 406747
URI: http://eprints.soton.ac.uk/id/eprint/406747
ISSN: 0307-0565
PURE UUID: e0e77b08-fc46-4b63-ad5f-c97a9f74bfd3
ORCID for S. R. Crozier: ORCID iD orcid.org/0000-0002-9524-1127
ORCID for H. M. Inskip: ORCID iD orcid.org/0000-0001-8897-1749
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for K. M. Godfrey: ORCID iD orcid.org/0000-0002-4643-0618
ORCID for N. C. Harvey: ORCID iD orcid.org/0000-0002-8194-2512
ORCID for S. M. Robinson: ORCID iD orcid.org/0000-0003-1766-7269

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Date deposited: 22 Mar 2017 02:05
Last modified: 18 Mar 2024 05:03

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Contributors

Author: J. L. Hollis
Author: S. R. Crozier ORCID iD
Author: H. M. Inskip ORCID iD
Author: C. Cooper ORCID iD
Author: K. M. Godfrey ORCID iD
Author: N. C. Harvey ORCID iD
Author: C. E. Collins
Author: S. M. Robinson ORCID iD
Corporate Author: Southampton Women's Survey Study Group

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