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Clinical Studies and Practice

Modifiable risk factors of maternal postpartum weight retention: an analysis of their combined impact and potential opportunities for prevention

International Journal of Obesity volume 41, pages 1091–1098 (2017)Cite this article

Subjects

Abstract

Background/Objectives:

Pregnancy triggers a physiological change in weight status. Postpartum weight retention in the childbearing years can substantially alter a woman’s weight gain trajectory, with several potential contributing factors identified. Most research has relied on women’s recall of pre-pregnancy weight during pregnancy or later, and not considered risk factors in combination. Using measured pre-pregnancy weight, this study aimed to examine the associations of maternal postpartum weight retention with parity, pre-pregnancy BMI, excessive gestational weight gain (GWG), maternal serum vitamin D concentration and dietary Glycaemic Index in early and late pregnancy, and breastfeeding duration, including analysis of the combined impact of potentially modifiable risk factors.

Subjects/Methods:

Prospective cohort study of 12 583 non-pregnant women aged 20–34 years in Southampton (UK) who were assessed prior to pregnancy, with those who subsequently became pregnant followed up in early and late gestation, and after delivery (n=2559 in the final sample). Linear regression models examined potential predictors of weight retention in adjusted individual and multivariate analyses, and as a risk factor score.

Results:

Compared with pre-pregnancy weight, 73% of women retained some weight at 6 months postpartum (mean (s.d.): 3.5 (6.2) kg). In the adjusted multivariate model, women who were primiparous, had a lower pre-pregnancy BMI, excessive GWG, a lower early pregnancy vitamin D concentration and breastfed for <6 months had greater weight retention 6 months postpartum (P<0.05 for all variables). For each additional modifiable risk factor (excessive GWG, low vitamin D concentration in early pregnancy and short breastfeeding duration; scale 0–3), women retained an additional 2.49 kg (95% CI: 2.16, 2.82; P<0.001).

Conclusions:

Having a greater number of modifiable risk factors was associated with greater weight retention 6 months postpartum. Initiatives supporting women to target these risk factors in the years prior to, during and after pregnancy could impact on their weight gain trajectory and later risk of adverse weight-related outcomes.

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Acknowledgements

We are grateful to the women of Southampton and their children who gave their time to take part in these studies, and to the research nurses and other staff who collected and processed the data. This work was supported by grants from the UK Medical Research Council, the British Heart Foundation, UK Foods Standard Agency, the Dunhill Medical Trust, the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre, the European Union's Seventh Framework Programme (FP7/2007-2013), and projects EarlyNutrition and ODIN (under grant agreement numbers 289346 and 613977). JLH received an Endeavour Research Fellowship funded by the Australian Government (Department of Education and Training). CEC is supported by a National health and Medical research Council of Australia Senior Research Fellowship.

Author contributions

All authors were responsible for the design of the study and formulated the research question. JLH conducted the statistical analysis under the guidance of SRC. JLH completed the literature review and drafted the initial paper. All authors were responsible for revising the manuscript and have approved the final version.

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Authors and Affiliations

  1. Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK

    J L Hollis, S R Crozier, H M Inskip, C Cooper, K M Godfrey, N C Harvey & S M Robinson

  2. NIHR Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK

    J L Hollis, H M Inskip, C Cooper, K M Godfrey, N C Harvey & S M Robinson

  3. NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK

    C Cooper

  4. Priority Research Centre in Physical Activity and Nutrition, School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia

    C E Collins

  5. Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia

    C E Collins

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  1. J L Hollis
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Correspondence to S M Robinson.

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Competing interests

KMG has received reimbursement for speaking at conferences sponsored by companies selling nutritional products; KMG, HMI and CC are part of an academic consortium that has received research funding from Abbott Nutrition, Nestec and Danone. The remaining authors declare no conflict of interest.

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Hollis, J., Crozier, S., Inskip, H. et al. Modifiable risk factors of maternal postpartum weight retention: an analysis of their combined impact and potential opportunities for prevention. Int J Obes 41, 1091–1098 (2017). https://doi.org/10.1038/ijo.2017.78

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