Does the pattern of postpartum weight change differ according to pregravid body size?

Abstract

OBJECTIVES: To examine differences in the pattern of weight changes during and after pregnancy among four pregravid body mass index (BMI) groups. STUDY DESIGN: Prospective cohort study of women who had two consecutive births at the University of California, San Francisco (UCSF) between 1980 and 1990. MEASUREMENTS: Maternal body weights were available before conception and delivery, and at 6 weeks postpartum for the ®rst (index) pregnancy, and before conception for the second study pregnancy. Height and two pregravid weights were selfreported. Weights at delivery and 6 weeks postpartum were measured. Net delivery weight was de®ned as delivery weight minus infant birth weight. Three non-overlapping sequential weight changes were constructed: (1) net gestational gain (net delivery weight minus pregravid weight at the index pregnancy); (2) early net postpartum weight change (6-week postpartum weight minus net delivery weight); and (3) late postpartum weight change (pregravid weight at the second pregnancy minus 6-week postpartum weight). SUBJECTS: A total of 985 healthy women (age 18 ± 41 y) from four raceaethnicity groups (Asian, Hispanic, black and white) who had a singleton, full-term, live birth for the index pregnancy followed by a second consecutive birth. RESULTS: Four raceaethnicity groups were combined (no interaction) to contrast average weight changes among pregravid BMI groups. Means adjusted for eight covariates (parity, raceaethnicity, education, mode of delivery, smoking, hypertension of pregnancy, age, height) and time intervals were not altered appreciably. Early net postpartum weight losses were similar for all pregravid BMI groups. Late (median of 2 y) postpartum weight losses were 4 kg higher in the low and average BMI groups compared with the highest BMI group. About half of the net gestational gain was lost by 6 weeks postpartum, and the percentage that was lost decreased over time. CONCLUSIONS: This study suggests that early postpartum weight loss does not vary by maternal pregravid BMI group, but late postpartum weight change does. Serial weight measurements are needed in epidemiologic studies to differentiate retention of gestational gain from weight gain during the late postpartum period.

The association of pregnancy and the development of obesity – results of a systematic review and meta-analysis on the natural history of postpartum weight retention

“…Tables 1-3 summarize the results of the qualitative analysis. Fifteen prospective studies, 23,24,[29][30][31][32][33][34][35][36]38,[40][41][42][43][44][45] five retrospective studies, 22,[25][26][27][28]37,46 and the control group from a randomized controlled trial 39 were included in the final analysis. Studies in which women were recruited around the time of delivery and then followed prospectively for postpartum body weight (ambivalent design, as baseline weight was assessed retrospectively) 24,29,30,[34][35][36][44][45][46] were considered as prospective in design, as we wanted to focus on the development of postpartum weight change.…”

“…The majority of studies were conducted in North America [22][23][24]29,35,[37][38][39][40]42,45,46 and Europe, [25][26][27][28]34,36,41,43 where the magnitude of weight retention among women appears to be similar. 39 In developing countries, women retain less weight after pregnancy compared with women in developed countries.…”

“…[22][23][24][25][26][27][28][29][30][31][32][33][35][36][37][38][39][40][41][42][43][44][45][46] The study populations were mainly recruited from inpatients in departments of obstetrics. [24][25][26][31][32][33]35,36,[38][39][40][41][42][43][44][45][46] There was a higher percentage of low-income women in the studies conducted in North America, but socio-economic status was thought to be homogeneous across studies. 35,37,39,42,45,46 The sample size varied between 47 and 1423 women.…”

“…23,27,28,35,39,41,46 Four studies had sample sizes of over 500 women. 24,36,38,40 Studies were judged homogeneous regarding participants' age. Most studies included primarily adult women.…”

Parametric model of human body shape and ligaments for patient-specific epidural simulation

“…Body mass increase during the following 34 weeks resembles a sigmoid curve [17]. Total net gain by gestational week 40 is 12-15 kg [18]. By 6 weeks postpartum half of the net gestational gain is lost.…”