Nine months postpartum weight retention predictors for Brazilian women

Kac, Gilberto; Benício, Maria Helena D’Aquino; Velásquez-Meléndez, Gustavo; Valente, Joaquim Gonçalves

doi:10.1079/phn2003579

Cited by 65 publications

(91 citation statements)

References 31 publications

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“…Rode (2011) Walker (2004) Amorim ( association between GWG and PPWR are unknown, the present meta-analyses and the previous studies suggest that inadequate GWG affected PPWR, which decreased over postpartum time (22,28) . However, the potential beneficial effect of inadequate GWG on PPWR should be balanced against the potential risks of inadequate GWG for underweight women because underweight women would probably benefit from weight gain.…”

Section: Study Idmentioning

confidence: 57%

“…Thus, thirty-five full-text articles were screened for detailed evaluation, among which seventeen studies were excluded because of having too short a follow-up time (<4 weeks; six studies), the arbitrary categorization of GWG (four studies) and missing data on GWG and PPWR (seven studies). Two studies described the aspects of the same study, but only the study reporting the PPWR was used (14,22) . Thus, seventeen studies, two of which were obtained from reference lists, were included in the present meta-analysis (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(23)(24)(25)(26) .…”

Section: Resultsmentioning

confidence: 99%

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Pre-pregnancy BMI, gestational weight gain and postpartum weight retention: a meta-analysis of observational studies

Han

et al. 2014

Public Health Nutr.

167

142

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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

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Section: Study Idmentioning

confidence: 57%

Section: Resultsmentioning

confidence: 99%

Pre-pregnancy BMI, gestational weight gain and postpartum weight retention: a meta-analysis of observational studies

Han

et al. 2014

Public Health Nutr.

167

142

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“…Nutritional restriction is discouraged even for obese women in the postpartum period, and methods that emphasize a fast weight loss are not recommended (14) . Approximately 13-20 % of women do not return to their pre-pregnancy weight, showing significant postpartum weight retention (15)(16)(17) . More than two-thirds of women face some degree of weight retention at 6 weeks postpartum (18) .…”

Section: Postpartum Bmi Fibre Intake Maternal Obesitymentioning

confidence: 99%

Fibre intake and evolution of BMI: from pre-pregnancy to postpartum

Drehmer

Camey

Nunes

et al. 2012

Public Health Nutr.

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Objective: To evaluate the effect of fibre intake on the evolution of maternal BMI from pregnancy to postpartum and to identify dietary patterns associated with fibre intake. Design: Cohort study. Food intake was obtained using an FFQ. Focused principal component analysis was used focusing on the variables: postpartum weight retention and total dietary fibre intake. Poisson regression models with robust variance were built in order to measure the effect of fibre intake during the postpartum period on obesity risk. Setting: Primary care clinics in southern Brazil. Subjects: Pregnant women (n 370) were followed until the 5th month postpartum. Results: The highest contribution to fibre intake came from the consumption of beans. Consumption of bread and rice indicated a common Brazilian food pattern along with beans. Participants retained a median of 4?4 (interquartile range 0?6, 7?9) kg of weight gained during pregnancy. Obesity risk, defined as an unfavourable evolution of BMI during pregnancy and postpartum, was present in 189 (55?1 %) women. Individual food items did not have an important effect on weight retention. In Poisson regression adjusting for maternal age, pre-pregnancy BMI and total gestational weight gain, inadequate postpartum fibre intake increased obesity risk by 24 % (relative risk 5 1?24; 95 % CI 1?05, 1?47). Conclusions: Important maternal weight retention occurred in these women. Adequate fibre intake may reduce obesity risk in the period following childbirth. Keywords Postpartum BMI Fibre intake Maternal obesityThe postpartum period appears to be a critical period for obesity development in women of reproductive age due to maternal weight retention determined by a series of interrelated factors (1,2) . Gestational weight gain above the recommendations of the Institute of Medicine (IOM) is considered the most important predictor for postpartum weight retention, increasing the short-, medium-and long-term risk obesity (3)(4)(5)(6)(7)(8) .Among other factors associated with postpartum weight variation, maternal age, parity, social and demographic factors as well as pre-pregnancy nutritional status represent non-modifiable factors or ones that occur before pregnancy (1,2) . Modifiable factors related to lifestyle, such as diet, physical activity, smoking and lactation, and their effects on the postpartum weight evolution, are still relatively underexplored in the literature (9)(10)(11)(12) .Maternal energy intake needs to be increased in both pregnancy and postpartum in order to meet physiological demands. The American Dietetic Association recommends that food intake in pregnancy and the postpartum period should be based on whole grains, fruit and vegetables, aiming at meeting recommended vitamin and mineral contents (13) . Nutritional restriction is discouraged even for obese women in the postpartum period, and methods that emphasize a fast weight loss are not recommended (14) . Approximately 13-20 % of women do not return to their pre-pregnancy weight, showing significant postpartum weig...

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“…Diferenças nas taxas finais de seguimento foram avaliadas segundo o teste do qui-quadrado para proporções. Detalhes adicionais acerca do recrutamento, seleção de participantes, critérios de exclusão, coleta de dados antropométricos e padrão de perdas podem ser obtidos em publicações anteriores [17][18][19][20][21] .…”

Section: Métodosunclassified

“…A incidência geral de macrossomia foi de 4,8%, sendo de 10,4% para os filhos de mulheres com ganho de peso gestacional excessivo e de 2,5% para os filhos de mulheres com ganho de peso gestacional normal. Mulheres com ganho de peso gestacional excessivo e > 20 anos apresentaram razão de chance não-ajustada 5,42 vezes maior de ter filhos com macrossomia (IC 95%: 1,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)34). Apenas o ganho de peso gestacional excessivo (OR = 5,83, IC 95%: 1,51-22,48) permaneceu associado à macrossomia no modelo final de regressão logística.…”

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Gestational weight gain and macrosomia in a cohort of mothers and their children

Kac¹,

Velásquez-Meléndez²

2005

J Pediatr (Rio J)

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Objective: To identify co-variables potentially associated to infant macrosomia, including excessive gestational weight gain.Methods: A cohort was investigated consisting of 230 pairs of mothers and children, residents of the City of Rio de Janeiro. Fetal macrosomia, defined as a birth weight > 4,000 grams was treated as the dependent variable. Statistical analysis of the relation between macrosomia and co-variables involved stratified analysis and multivariate logistic regression, which estimates odds ratios (OR) and 95% confidence intervals (CI 95%).Results: The incidence of excessive gestational weight gain was 29.1%, varying from 10% for women under 20 years to 63.6% for women who had given birth to children with macrosomia. Macrosomia incidence was 4.8% for the group as a whole, 10.4% for women with excessive gestational weight gain and 2.5% for women with normal gestational weight gain. Women with excessive gestational weight gain and > 20 years exhibited a chance of developing macrosomia that was 5.42 times greater (CI 95%: 1.11 -26.34). Within the final multivariate logistic regression model, only excessive gestational weight gain (OR = 5.83, CI 95%: 1.51 -22.48) remained associated to infant macrosomia. Conclusions:Considering that excessive gestational weight gain was the only predictor related to macrosomia, it is important that preventive programs that take account of this predictor be implemented, avoiding undesirable fetal outcomes. Future studies should include a wider variety of macrosomia predictors and additional birth outcomes.J Pediatr (Rio J). 2005;81(1):47-53: Fetal macrosomia, birth weight, weight gain, pregnancy, obesity, health transition. ResumoObjetivo: Identificar co-variávies potencialmente associadas à macrossomia, incluindo o ganho de peso gestacional excessivo.Métodos: Foram investigados 230 pares de mães e filhos residentes no município do Rio de Janeiro, Brasil, utilizando-se desenho de coorte. A macrossomia, definida como valores de peso ao nascer > 4.000 g, constituiu-se na variável dependente. Os potenciais preditores da macrossomia foram avaliados através de análise estratificada e da técnica de regressão logística não-condicional, que estima a odds ratio (OR) e os respectivos intervalos de confiança (IC 95%).Resultados: A incidência de ganho de peso gestacional excessivo foi de 29,1%, variando de 10% em mulheres com < 20 anos a 63,6% em mulheres que geraram filhos com macrossomia. A incidência geral de macrossomia foi de 4,8%, sendo de 10,4% para os filhos de mulheres com ganho de peso gestacional excessivo e de 2,5% para os filhos de mulheres com ganho de peso gestacional normal. Mulheres com ganho de peso gestacional excessivo e > 20 anos apresentaram razão de chance não-ajustada 5,42 vezes maior de ter filhos com macrossomia (IC 95%: 1,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)34). Apenas o ganho de peso gestacional excessivo (OR = 5,83, IC 95%: 1,51-22,48) permaneceu associado à macrossomia no modelo final de regressão logística.Conclusões:...

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Nine months postpartum weight retention predictors for Brazilian women

Cited by 65 publications

References 31 publications

Pre-pregnancy BMI, gestational weight gain and postpartum weight retention: a meta-analysis of observational studies

Pre-pregnancy BMI, gestational weight gain and postpartum weight retention: a meta-analysis of observational studies

Fibre intake and evolution of BMI: from pre-pregnancy to postpartum

Gestational weight gain and macrosomia in a cohort of mothers and their children

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