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

Published online by Cambridge University Press:  01 October 2020

Diana Cristina Soria-Contreras
Affiliation:
Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
Martha María Téllez-Rojo
Affiliation:
Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
Alejandra Cantoral
Affiliation:
Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico National Council on Science and Technology, Mexico City, Mexico
María Luisa Pizano-Zárate
Affiliation:
Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
Emily Oken
Affiliation:
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
Andrea A Baccarelli
Affiliation:
Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
Allan C Just
Affiliation:
Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Manuela A Orjuela
Affiliation:
Departments of Epidemiology, Mailman School of Public Health, and Pediatrics, Columbia University Medical Center, New York, NY, USA
Ivonne Ramírez-Silva
Affiliation:
Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
Robert O Wright
Affiliation:
Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Belem Trejo-Valdivia*
Affiliation:
Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
Ruy López-Ridaura
Affiliation:
Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
*
*Corresponding author: Email bvaldivia@insp.mx

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.

Type
Research paper
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The Nutrition Society

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