Associations between gestational weight gain and BMI, abdominal adiposity, and traditional measures of cardiometabolic risk in mothers 8 y postpartum

McClure, Candace K.; Catov, Janet M.; Ness, Roberta B.; Bodnar, Lisa M.

doi:10.3945/ajcn.112.055772

Cited by 95 publications

(88 citation statements)

References 45 publications

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“…While this finding is supported by the ALSPAC data, 5 another study of 478 women from Pittsburgh reported no association between total GWG and SBP at 8 years postpartum, 6 perhaps because total GWG incorporates both early GWG, which was directly related to SBP, as well as later GWG, which was not. In our study, GWG rate was not related to HOMA-IR, perhaps because of the relatively short postpartum follow-up period that may fail to capture the natural time course of developing insulin resistance, or the smaller sample size for this outcome.…”

Section: Discussionmentioning

confidence: 83%

Associations of trimester-specific gestational weight gain with maternal adiposity and systolic blood pressure at 3 and 7 years postpartum

Walter

Perng

Kleinman

et al. 2015

American Journal of Obstetrics and Gynecology

128

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OBJECTIVE Our objective was to examine the associations of total and trimester-specific gestational weight gain (GWG) rate with postpartum maternal weight and cardiometabolic risk. We hypothesized the first trimester GWG would be most strongly associated with long-term maternal health. METHODS We studied 801 women enrolled during the 1st trimester of pregnancy in the Boston-area Project Viva cohort 1999–2002. At 3 years postpartum we measured maternal weight, waist circumference, and systolic blood pressure (SBP) and collected fasting blood from a subset. At 7 years postpartum we again measured weight and waist circumference. We used multivariable linear regression to evaluate relations of total and trimester-specific GWG rate with weight change (vs. self-reported pre-pregnancy weight) and waist circumference at each timepoint, stratified by pre-pregnancy weight, as well as associations with SBP and insulin resistance at 3 years. RESULTS Median age at enrollment was 34.0 years (range: 16.4–44.9); 65% were white. Mean (SD) total GWG rate was 0.38 (0.14) kg/week. Women gained weight faster during the second (0.47 [0.19] kg/week) and third trimesters (0.44 [0.22] kg/week) than the first (0.22 [0.22] kg/week). Total and first trimester GWG rate were most strongly associated with postpartum weight change. Among normal weight women, each 1 SD increase in total and first trimester GWG rate corresponded with 0.85 (95% CI: 0.07, 1.63) kg and 2.08 (1.32, 2.84) kg greater weight change at 3 and 7 years postpartum respectively, but there was not strong evidence of association for either second (−0.30 kg; 95% CI: −1.08, 0.48) or third trimester (−0.26 kg; 95% CI: −1.08, 0.55) GWG. First trimester GWG rate also related to 3-year postpartum weight change in overweight (2.28 kg; 95% CI: 0.95, 3.61) and obese (2.47 kg; 95% CI: 0.98, 3.97) women. Greater total and first trimester GWG rate were associated with larger waist circumference and higher SBP but not insulin resistance. CONCLUSION In this observational cohort, first trimester weight gain was more strongly associated with maternal weight retention as well as higher waist circumference and blood pressure than 2nd or 3rd trimester gain. Interventions targeting GWG beginning very early in pregnancy may benefit long-term maternal health.

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Section: Discussionmentioning

confidence: 83%

Associations of trimester-specific gestational weight gain with maternal adiposity and systolic blood pressure at 3 and 7 years postpartum

Walter

Perng

Kleinman

et al. 2015

American Journal of Obstetrics and Gynecology

128

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“…Although the effects of excess gestational weight gain on triglycerides are sparse and inconclusive, a recent study in overweight/obese pregnant women showed that mothers with excess gestational weight gain also had higher baseline triglycerides (81.7±47.2 vs. 69.7±40.3 mg/dl) when compared to normal weight women. 69 Other studies, such as McClure et al, 50 found that although the 47% of women who gained excessively did not alter their triglycerides, they had the highest rate of metabolic syndrome. The effects of excess GWG go well beyond pregnancy as women who experience excess GWG, have higher incidence of metabolic syndrome and decreased HDL cholesterol levels at 8 years postpartum.…”

Section: Postpartum Weight Retention and Body Compositionmentioning

confidence: 97%

“…49 Women with excessive GWG, have 3 times greater incidence of abdominal obesity at 8 years postpartum compared with women who gained weight in pregnancy as recommended. 50 In addition to the contribution of excess GWG to increased postpartum abdominal adiposity, parity also correlates positively with increased adnominal adiposity and visceral fat accumulation indicating that the vicious cycle of weight gain in pregnancy and postpartum may be worse than at first glance since weight is being retained as visceral adipose tissue, a potent precursor of metabolic disease. 51,52 Primiparas women gained 13 cm 2 of total abdominal adipose tissue more than women with no children, with total 5 year mean increase in visceral adipose tissue of 15.1 cm 2 with effects persisting to 15 years postpartum.…”

Section: Postpartum Weight Retention and Body Compositionmentioning

confidence: 99%

Pregnancy as a window to future health: Excessive gestational weight gain and obesity

Gilmore

Klempel-Donchenko

Redman

2015

Seminars in Perinatology

163

140

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Metabolic and behavioral changes that occur during pregnancy have well-known effects on maternal and fetal health during the immediate pregnancy and now are thought to be a catalyst for future health throughout later life. Recommendations for appropriate gestational weight gain (GWG) and lifestyle modifications during pregnancy have changed throughout history as more is known about this crucial time. Herein we discuss the current GWG recommendations and the impact of pregnancy and excess GWG gain on the current and future health of women and children including risk of obesity, gestational diabetes, type II diabetes, cardiovascular disease, and metabolic syndrome.

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“…This might be due to excessive gestational weight gain (GWG), lack of breastfeeding, or shorter breastfeeding duration (3)(4)(5)(6)(7). However, these studies had not controlled for measures of maternal abdominal fat mass before pregnancy.…”

Section: Introductionmentioning

confidence: 96%

Maternal prepregnancy waist circumference and BMI in relation to gestational weight gain and breastfeeding behavior: the CARDIA study

Kirkegaard¹,

Nøhr

Rasmussen

et al. 2015

The American Journal of Clinical Nutrition

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Associations between gestational weight gain and BMI, abdominal adiposity, and traditional measures of cardiometabolic risk in mothers 8 y postpartum

Abstract: Excessive GWG is associated with long-term maternal abdominal adiposity, which may increase a woman's risk of cardiovascular and metabolic disease.

Cited by 95 publications

References 45 publications

Associations of trimester-specific gestational weight gain with maternal adiposity and systolic blood pressure at 3 and 7 years postpartum

Associations of trimester-specific gestational weight gain with maternal adiposity and systolic blood pressure at 3 and 7 years postpartum

Pregnancy as a window to future health: Excessive gestational weight gain and obesity

Maternal prepregnancy waist circumference and BMI in relation to gestational weight gain and breastfeeding behavior: the CARDIA study

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