Objective: To determine the association of gestational weight gain (GWG) or pre-pregnancy BMI with postpartum weight retention (PPWR). Design: Meta-analysis. Setting: PubMed, Cochrane Controlled Trials Register, EMBASE, Science Citation Index Expanded, Current Contents Connects and Biosis Previews were used to search articles. Subjects: Publications that described the influence of pre-pregnancy BMI or GWG on PPWR. Results: Seventeen studies that satisfied the eligibility criteria were included in the analyses. Women with inadequate and excessive GWG had significantly lower mean PPWR of − 2·14 kg (95 % CI -2·43, -1·85 kg) and higher PPWR of 3·21 kg (95 % CI 2·79, 3·62 kg), respectively, than women with adequate GWG. When postpartum time spans were stratified into 1-3 months, 3-6 months, 6-12 months, 12-36 months and ≥15 years, the association between inadequate GWG and PPWR faded over time and became insignificant (−1·42 kg; 95 % CI −3·08, 0·24 kg) after ≥15 years. However, PPWR in women with excess GWG exhibited a U-shaped trend; that is, a decline during the early postpartum time span (year 1) and then an increase in the following period. Meta-analysis of qualitative studies showed a significant relationship between excessive GWG and higher PPWR risk (OR = 2·08; 95 % CI 1·60, 2·70). Moreover, meta-analysis of pre-pregnancy BMI on PPWR indicated that mean PPWR decreased with increasing BMI group. Conclusions: These findings suggest that GWG, rather than pre-pregnancy BMI, determines the shorter-or longer-term PPWR.
Keywords
Gestational weight gain Postpartum weight retention BMIOverweight and obesity are associated with increased risks of morbidity and mortality related to CVD, diabetes, kidney diseases and certain cancers (1) . In recent decades, the prevalence of both overweight and obesity has been increasing steadily in all age groups worldwide (2) . One of the natural and biological causes of weight recycling in women is pregnancy. Pregnancy is a period in most women's lives when substantial weight is gained, considerably altering their future weight-gain trajectory (3) . The obesity epidemic has demonstrated that weight gain from pregnancy may lead to obesity development (4) . Approximately 10 % to 15 % of women retain the weight they gain during pregnancy on a long-term basis and a number of these ultimately become obese (4) . Thus, the pregnancy-postpartum period is critical because it can significantly affect long-term weight management and predispose women to chronic diseases later in life. Pre-pregnancy BMI, gestational weight gain (GWG) and postpartum weight retention (PPWR) are not only nutritional problems but may also be related to activity, genetic and psychological factors faced by women of childbearing age. According to a review by Gunderson and Abrams, PPWR is presumably due to a combination of several factors, such as dietary intake, lack of physical activity, lactation, smoking status, pre-pregnancy BMI, GWG and parity, and is associated with increased risks of long-term
