Advertisement

Maternal and Child Health Journal

, Volume 22, Issue 9, pp 1339–1344 | Cite as

Association of Pre-pregnancy BMI and Postpartum Weight Retention Before Second Pregnancy, Washington State, 2003–2013

  • Tyler G. Ketterl
  • Nicolas J. Dundas
  • Steven A. Roncaioli
  • Alyson J. Littman
  • Amanda I. Phipps
Article

Abstract

Background Maternal overweight and obesity is one of the most common high-risk obstetric conditions associated with adverse birth outcomes. Smaller studies have suggested that pre-pregnancy body mass index (BMI) is associated with postpartum weight retention. Objective The primary objective of this study was to examine the association between pre-pregnancy BMI status and maternal weight retention. Study design We conducted a population-based retrospective cohort study using Washington State birth certificate data from 2003–2013. We included women who had two sequential births during this time period, with the second birth occurring within 18–36 months of the first singleton delivery date. BMI before a women’s first pregnancy (“pre-pregnancy BMI”) was categorized as normal (18.5–24.9 kg/m2) and overweight/obese (25–40 kg/m2). Women were classified as having returned to first pre-pregnancy BMI if their BMI before their second pregnancy was no more than 1 kg/m2 more compared to their BMI before their first pregnancy. Analyses were stratified by gestational weight gain during the first pregnancy (below, met, exceeded recommended gestational weight gain). Results A total of 49,132 mothers were included in the study. Among women who met their recommended gestational weight gain, compared to mothers with a normal BMI, obese/overweight mothers were less likely to return to their pre-pregnancy BMI (76.5 vs 72.3%; RRObese/Overweight = 0.88; 95% CI: 0.85–0.92). A similar pattern was observed among women who exceeded their recommended gestational weight gain (62.6 vs 53.2%; RRObese/Overweight = 0.79, 95% CI: 0.78–0.80). Conclusion Pre-pregnancy BMI in the overweight/obese range is associated with a decreased likelihood of returning to pre-pregnancy BMI. Further research to support women during and after their pregnancy to promote behavior changes that prevent excessive weight gain during pregnancy and weight retention after birth is needed.

Keywords

Body mass index Gestational weight gain Obesity Overweight Postpartum weight retention 

Notes

Acknowledgements

This investigation was supported by the National Institutes of Health under Ruth L. Kirschstein National Research Service Award T32CA009351.

Compliance with Ethical Standards

Conflict of interest

The authors report no conflict of interest.

References

  1. About Adult BMI | Healthy Weight | CDC. (2017, August). Retrieved August 7, 2017, from https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html.
  2. Amorim, A. R., Rössner, S., Neovius, M., Lourenço, P. M., & Linné, Y. (2007). Does excess pregnancy weight gain constitute a major risk for increasing long-term BMI? Obesity, 15(5), 1278–1286.  https://doi.org/10.1038/oby.2007.149.CrossRefPubMedGoogle Scholar
  3. Catalano, P. M., & Shankar, K. (2017). Obesity and pregnancy: Mechanisms of short term and long term adverse consequences for mother and child. BMJ, 356, j1.  https://doi.org/10.1136/bmj.j1.CrossRefPubMedGoogle Scholar
  4. Flegal, K. M., Carroll, M. D., Ogden, C. L., & Johnson, C. L. (2002). Prevalence and trends in obesity among US adults, 1999–2000. JAMA, 288(14), 1723–1727.  https://doi.org/10.1001/jama.288.14.1723.CrossRefPubMedGoogle Scholar
  5. Forthun, I., Wilcox, A. J., Strandberg-Larsen, K., Moster, D., Nohr, E. A., Lie, R. T., … Tollånes, M. C. (2016). Maternal prepregnancy BMI and risk of cerebral palsy in offspring. Pediatrics, 138(4), e20160874.  https://doi.org/10.1542/peds.2016-0874.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Goldstein, R. F., Abell, S. K., Ranasinha, S., Misso, M., Boyle, J. A., Black, M. H., … Teede, H. J. (2017). Association of gestational weight gain with maternal and infant outcomes: A systematic review and meta-analysis. JAMA, 317(21), 2207–2225.  https://doi.org/10.1001/jama.2017.3635.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Gould Rothberg, B. E., Magriples, U., Kershaw, T. S., Rising, S. S., & Ickovics, J. R. (2011). Gestational weight gain and subsequent postpartum weight loss among young, low-income, ethnic minority women. American Journal of Obstetrics and Gynecology, 204(1), 52.e1-11.  https://doi.org/10.1016/j.ajog.2010.08.028.CrossRefPubMedGoogle Scholar
  8. Gunderson, E. P. (2009). Childbearing and obesity in women: Weight before, during, and after pregnancy. Obstetrics and Gynecology Clinics of North America, 36(2), 317.  https://doi.org/10.1016/j.ogc.2009.04.001.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Gunderson, E. P., & Abrams, B. (2000). Epidemiology of gestational weight changes after pregnancy. Epidemiologic Reviews, 22(2), 261–274.  https://doi.org/10.1093/oxfordjournals.epirev.a018038.CrossRefPubMedGoogle Scholar
  10. Heslehurst, N., Ells, L., Simpson, H., Batterham, A., Wilkinson, J., & Summerbell, C. (2007). Trends in maternal obesity incidence rates, demographic predictors, and health inequalities in 36 821 women over a 15-year period. BJOG: An International Journal of Obstetrics & Gynaecology, 114(2), 187–194.  https://doi.org/10.1111/j.1471-0528.2006.01180.x.CrossRefGoogle Scholar
  11. Koh, H., Ee, T. X., Malhotra, R., Allen, J. C., Tan, T. C., & Østbye, T. (2013). Predictors and adverse outcomes of inadequate or excessive gestational weight gain in an Asian population. The Journal of Obstetrics and Gynaecology Research, 39(5), 905–913.  https://doi.org/10.1111/j.1447-0756.2012.02067.x.CrossRefPubMedGoogle Scholar
  12. Krause, K. M., Lovelady, C. A., Peterson, B. L., Chowdhury, N., & Østbye, T. (2010). Effect of breast-feeding on weight retention at 3 and 6 months postpartum: Data from the North Carolina WIC Programme. Public Health Nutrition, 13(12), 2019–2026.  https://doi.org/10.1017/S1368980010001503.CrossRefPubMedGoogle Scholar
  13. Kristensen, J., Vestergaard, M., Wisborg, K., Kesmodel, U., & Secher, N. J. (2005). Pre-pregnancy weight and the risk of stillbirth and neonatal death. BJOG: An International Journal of Obstetrics & Gynaecology, 112(4), 403–408.  https://doi.org/10.1111/j.1471-0528.2005.00437.x.CrossRefGoogle Scholar
  14. Lederman, S. A., Alfasi, G., & Deckelbaum, R. J. (2002). Pregnancy-associated obesity in black women in New York City. Maternal and Child Health Journal, 6(1), 37–42.  https://doi.org/10.1023/A:1014364116513.CrossRefPubMedGoogle Scholar
  15. Meštrović, Z., Roje, D., Vulić, M., & Zec, M. (2017). Calculation of optimal gestation weight gain in pre-pregnancy underweight women due to body mass index change in relation to mother’s height. Archives of Gynecology and Obstetrics, 295(1), 81–86.  https://doi.org/10.1007/s00404-016-4218-3.CrossRefPubMedGoogle Scholar
  16. Ohlin, A., & Rössner, S. (1990). Maternal body weight development after pregnancy. International Journal of Obesity, 14(2), 159–173.PubMedGoogle Scholar
  17. Oken, E., Kleinman, K. P., Belfort, M. B., Hammitt, J. K., & Gillman, M. W. (2009). Associations of gestational weight gain with short- and longer-term maternal and child health outcomes. American Journal of Epidemiology, 170(2), 173–180.  https://doi.org/10.1093/aje/kwp101.CrossRefPubMedPubMedCentralGoogle Scholar
  18. Østbye, T., Krause, K. M., Swamy, G. K., & Lovelady, C. A. (2010). Effect of breastfeeding on weight retention from one pregnancy to the next: Results from the North Carolina WIC program. Preventive Medicine, 51(5), 368–372.  https://doi.org/10.1016/j.ypmed.2010.07.017.CrossRefPubMedGoogle Scholar
  19. Parker, J. D., & Abrams, B. (1993). Differences in postpartum weight retention between black and white mothers. Obstetrics and Gynecology, 81(5 (Pt 1)), 768–774.PubMedGoogle Scholar
  20. Rasmussen, K. M., Catalano, P. M., & Yaktine, A. L. (2009). New guidelines for weight gain during pregnancy: What obstetrician/gynecologists should know. Current Opinion in Obstetrics & Gynecology, 21(6), 521–526.  https://doi.org/10.1097/GCO.0b013e328332d24e.CrossRefGoogle Scholar
  21. Usha Kiran, T. S., Hemmadi, S., Bethel, J., & Evans, J. (2005). Outcome of pregnancy in a woman with an increased body mass index. BJOG: An International Journal of Obstetrics & Gynaecology, 112(6), 768–772.  https://doi.org/10.1111/j.1471-0528.2004.00546.x.CrossRefGoogle Scholar
  22. Walker, L. O., Timmerman, G. M., Sterling, B. S., Kim, M., & Dickson, P. (2004). Do low-income women attain their pre-pregnant weight by the 6th week of postpartum? Ethnicity & Disease, 14(1), 119–126.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Epidemiology, School of Public HealthUniversity of WashingtonSeattleUSA
  2. 2.Department of Health Services, School of Public HealthUniversity of WashingtonSeattleUSA
  3. 3.Fred Hutchinson Cancer Research CenterSeattleUSA

Personalised recommendations