Weight retention 12 months postpartum: association with sociodemographic, gestational and puerperal factors / Retenção de peso 12 meses pós-parto: associação com fatores sociodemográficos, gestacionais e puerperais

Abstract Objectives: to investigate the association between sociodemographic, gestational/puerperal factors and postpartum weight retention (PPWR) after 12 months in Brazilian women at a university hospital. Methods: prospective cohort with puerperal women recruited at the maternity ward of a university hospital in a Brazilian metropolis. At baseline (n=260), sociodemographic and anthropometric information on the mother-child binomial and data related to the gestational period were collected. Maternal dietary patterns were measured using a food frequency questionnaire and subsequently determined by Principal Component Analysis. Results: 75 women, with a mean age of 28.4 years (CI95%= 27.0-29.7), 25.3% with excessive PPPR, with an average of 3.6 kg (CI95%= 1.7) continued in the follow-up. -5.4). Higher gestational weight gain (GWG) (ß= 0.36; CI95%= 0.18-0.70) and lower maternal age (ß= -0.41; CI95%= -0.92--0.22) were PRPP predictors (p=0.001) (adjusted for per capita income, parity, type of delivery, number of prenatal visits, baby's birth weight, breastfeeding and physical activity). Conclusion: there was a high occurrence of excessive PPPR, favored by higher GPG and lower maternal age. This highlights the importance of monitoring women's health during the reproductive period, with guidance on ways of life (diet and physical activity), to favor better outcomes for mother-child.

Resumo Objetivos: investigar a associação entre fatores sociodemográficos, gestacionais/puerperais com a retenção de peso pós-parto (RPPP) após 12 meses em mulheres brasileiras em hospital universitário. Métodos: coorte prospectiva com puérperas recrutadas na maternidade do hospital universitário de uma metrópole brasileira. Na linha de base (n=260) foram coletadas informações sociodemográficas, antropométricas do binômio mãe-filho e dados relativos ao período gestacional. O padrão alimentar materno foi mensurado por meio do questionário de frequência alimentar e posteriormente determinado pela Análise de Componentes Principais. A RPPP foi classificada como risco para obesidade se ≥7,5Kg. Resultados: 75 mulheres continuaram no seguimento, com média de 28,4 anos de idade (IC95%= 27,0−29,7), 25,3% com RPPP excessiva, sendo em média 3,6 Kg (IC95%= 1,7−5,4). Maior ganho de peso gestacional (GPG) (β= 0,36; IC95%= 0,18-0,70) e menor idade materna (β= −0,41; IC95%= −0,92--0,22) foram preditores da RPPP (p≥0,001) (ajustado pela renda per capita, paridade, tipo de parto, número de consultas pré-natal, peso ao nascer do bebê, aleitamento materno e atividade física). Conclusão: evidenciou-se elevada ocorrência de RPPP excessiva, favorecida pelo maior GPG e menor idade materna. Aponta-se assim a importância do monitoramento da saúde da mulher durante o período reprodutivo, com orientações sobre modos de vida (alimentação e atividade física), para favorecer melhores desfechos para mãe-filho.

Analysis of the influencing factors and the adverse effect of gestational weight gain maternal and infant health in Beijing / 中华健康管理学杂志

Objective:To determine the gestational weight gain and its risk factors and adverse effects among pregnant women in Beijing.Methods:Between June 2018 and June 2019, all registered infants and their mothers in a child care center of a third-tier-class hospital in Beijing were selected. A self-made questionnaire was used to collect the basic information of the maternal mothers. Chi-square test and analysis of variance were used to describe the basic characteristics of the study subjects and clarify the harmful effect of gestational weight gain for maternal and infant health. Multiple logistic regression analysis was used to analyze the risk factors of both insufficient and excessive weight gain during pregnancy.Results:A total of 3732 maternal mothers and their babies were included. The average weight gain of maternal mothers during pregnancy was 13.0 kg. The results of this study showed that the proportion of insufficient weight gain during pregnancy was 31.8% and the proportion of excessive weight gain was 24.1%. It was further found that young age, pre-pregnancy body mass index indicating overweight and obesity, primipara, and low education were independent risk factors for excessive weight gain during pregnancy. The risk of excessive weight gain of pre-pregnancy overweight and obesity was 2.40 times ( OR=2.40, 95% CI=1.91-3.03, P<0.001) and 2.90 times higher, respectively, ( OR=2.90, 95% CI=1.59-5.27, P<0.001) when compared with that of pre-pregnancy normal weight. In addition, our results suggested that excessive weight gain significantly increased the risk of macrosomia for the infant and the risk of cesarean section, gestational hypertension, and postpartum weight retention for maternal mothers. Conclusions:Age, pre-pregnancy BMI, primipara, and education level were the influencing factors for gestational weight gain. Considering the serious harmful effects of both insufficient and excessive weight gain for maternal and infant health, weight management during pregnancy should be strengthened for these high-risk populations in the future.

Estado nutricional al inicio del embarazo, ganancias ponderales y retención de peso al año de paridas / Nutritional Condition at the Beginning of Pregnancy, Weight Gains and Weight Retention One Year after Delivery

Introducción: El embarazo es una etapa de riesgo de obesidad persistente después del parto, entre otras causas, es secundario al estado nutricional al inicio del embarazo y a las ganancias de peso por encima de lo recomendado. Objetivo: Describir las ganancias de peso gestacionales por categorías nutricionales y su asociación con la retención de peso al año del parto. Métodos: Se realizó un estudio observacional de corte transversal en 100 mujeres al año del parto, pertenecientes a tres áreas de salud del municipio Santa Clara, en el periodo comprendido de julio 2016 a julio 2017. Se revisaron los tarjetones de las embarazadas para recoger el peso en kg a la captación, su evaluación nutricional según el índice de masa corporal en la primera consulta y el peso al final de la gestación. Las mismas fueron visitadas en su domicilio al año de paridas; se recogieron datos generales, se midió la talla de pie, el peso corporal y la circunferencia de la cintura. Se calcularon los índices de masa corporal y cintura/talla. Resultados: Predominó la condición de peso adecuado a la captación (67,08 por ciento). El 82,87 por ciento de las mujeres retuvo peso al año de paridas; con mayor frecuencia en las obesas (90,0 por ciento) y sobrepeso (83,01 por ciento) según su estado nutricional a la captación. Todas las mujeres tuvieron índice cintura/talla por encima de 0,50 al año de paridas. Conclusiones: Las mujeres con mayores ganancias por encima de lo recomendado, tienen menor capacidad de recuperación del peso corporal al año de paridas(AU)

Introduction: Pregnancy is a period of persistent obesity risk after delivery. Among other causes, it is secondary to the nutritional status at the beginning of pregnancy and to gaining weight above the recommended. Objective: To describe gestational weight gains by nutritional categories and their association with weight retention one year after delivery. Methods: An observational and cross-sectional study was conducted with 100 women one year after delivery and from three health areas of Santa Clara Municipality, in the period from July 2016 to July 2017. Their pregnancy identification cards were reviewed to collect their weight in kilograms at the time pregnancy was identified, nutritional evaluation based on the body mass index at the first office visit, and the weight at the end of pregnancy. They were paid home visits one year after delivery. General data were collected, foot size, body weight, and waist circumference were measured. Body mass and waist/height indexes were calculated. Results: The weight condition adequate to the time pregnancy was identified (67.08 percent). 82.87 percent of women retained weight one year after delivery, more frequently in obese (90.0 percent) and overweight (83.01 percent) women according to their nutritional status at the time pregnancy was identified. All women had waist/height index above 0.50 one year after delivery. Conclusions: Women with weight gains higher than recommended have less capacity to recover their body weight one year after delivery(AU)

Gestational weight gain and optimal ranges in Chinese mothers giving singleton and full-term births in 2013 / 中华预防医学杂志

Objective@#To analyze the status of gestational weight gain (GWG) among Chinese mothers who gave singleton and full-term births, and to look at optimal GWG ranges.@*Methods@#In 2013, using the multi-stage stratified and population proportional cluster sampling method, we investigated 8 323 mother-child pairs at their 0-24 months postpartum from 55 counties (cities/districts) of 30 provinces (except Tibet) in mainland China. Questionnaire was used to collect data on body weight before pregnancy and delivery, diseases during gestation, hemorrhage or not at postpartum, child birth weight and length, and other information about pregnant outcomes. We measured mother's body weight and height, and child's body weight and length. Based on 'Chinese Adult Body Weight Standard’, we divided mothers into four groups according to their body weight before pregnancy: low weight (BMI<18.5 kg/m2), normal weight (BMI 18.5-23.9 kg/m2), overweight (BMI 24.0-27.9 kg/m2) and obesity (BMI≥28.0 kg/m2). The status of GWG was assessed by IOM optimal GWG guidelines. Chinese optimal GWG ranges were calculated according to the association of GWG with pregnant outcomes and anthropometry of mothers and children, and according to P25-P75 of GWG among mothers who had good pregnant outcomes and good anthropometry, and whose children had good anthropometry. The status of GWG was assessed by the new optimal ranges.@*Results@#P50 (P25-P75) of GWG among the 8 323 mothers was 15.0 (10.0-19.0) kg. According to the proposed optimal GWG ranges of IOM, the proportions of inadequate, optimal and excessive GWG accounted for 27.2% (2 263 mothers), 36.2% (3 016 mothers) and 36.6% (3 044 mothers). The optimal GWG ranges for low weight, normal weight, overweight and obesity were 11.5-18.0, 10.0-15.0, 8.0-14.0 and 5.0-11.5 kg. Based on these optimal GWG ranges established in this study, the rates of inadequate, optimal and excessive GWG were 15.7% (1 303 mothers), 45.0% (3 744 mothers) and 39.3% (3 276 mothers), and these rates were significantly different from that defined by the IOM standards (χ2=345.36, P<0.001).@*Conclusion@#The median of GWG among Chinese mothers is 15.0 kg, which is at a relatively higher level. This study suggests the optimal GWG ranges for Chinese women who give singleton and full-term babies, which appears lower than IOM's.

Métodos antropométricos utilizados na avaliação da retenção do peso no período pós-parto: uma revisão sistemática / Anthropometric methods used in the evaluation of the postpartum weight retention: a systematic review

Trata-se uma revisão sistemática de trabalhos científicos que estudaram a retenção de peso pós-parto. A identificação dos artigos foi feita nas bases de dados Medline, Lilacs e Biblioteca Digital de Teses e Dissertações, entre 2000 e 2013. As principais informações avaliadas foram: autor, ano de publicação, tamanho da amostra, ano de coleta, perdas e sua análise, idade, tempo de seguimento, peso no baseline e no pós-parto, métodos de avaliação da retenção de peso e principais resultados. Foram selecionados 20 estudos, destes 25% (n = 5) eram nacionais. Em relação à forma de análise, em alguns trabalhos, o mesmo desfecho foi analisado de diferentes maneiras, de forma contínua e categórica. Dos trabalhos selecionados, 45% (n = 9) analisaram o peso retido apenas de forma contínua, 5% (n = 1) apenas por categorias e 40% (n = 8) de ambas as maneiras. Um dos estudos utilizou distribuição percentilar e outro avaliou de forma contínua, categórica e por indicadores de redução absoluta e relativa de peso. Em conclusão, os resultados encontrados evidenciam a escassez de informações definidas acerca da avaliação antropométrica das mulheres no pós -parto, indicando a necessidade de elaboração de propostas nacionais, coerentes com a realidade de nossa população.

This paper is a systematic review of scientific papers that studied postpartum weight retention. The identification of the studies was conducted in the Medline, Lilacs and Digital Library of Theses and Dissertations databases between 2000 until 2013. The main information evaluated was: author, year of publication, sample size, year of data collection, losses and analysis thereof, age, follow-up time, weight in the baseline and in the postpartum, assessment methods of weight retention and main results. Twenty studies were selected, of which 25% (n = 5) were national. Regarding the mode of analysis, in some works the result was analyzed in different ways as continuous and categorical. Of the selected papers, 45% (n = 9) analyzed the retained weight only continuously, 5% (n = 1) only categorically and 40% (n = 8) both ways. One of the studies used distribution in percentiles and the other evaluated continuously, categorical and by indicators of absolute and relative weight reduction. In conclusion, the results found reveal a lack of well-defined information about the forms of anthropometric measurements of women after delivery, indicating the need for developing national proposals, consistent with the reality of our population.

Influence of sedentary behavior on weight retention among postpartum women within one year ;after childbirth / 中华流行病学杂志

Objective To identify the risk factors that affect the postpartum weight retention among women and provide evidence for the prevention of obesity and metabolic disorders due to childbirth. Methods The baseline data were collected from 1 220 postpartum women who had given childbirth 42 days ago in Hefei Maternal and Child Health Care Center,Anhui province. Their pre-pregnancy weight,weight gain during pregnancy and childbirth information were obtained from local maternal information management system,and the follow up for the women were conducted at 3,6,9,and 12 months after childbirth. The sedentary behaviors of the women were observed. The relationship between postpartum weight retention and sedentary behavior of the women were analyzed by mixed-effects model analysis and repeated measures analysis of variance. Results The pre-pregnancy average body weight(kg)of the women was(53.22 ± 6.88),and their postpartum average body weight retention was(7.85±5.11),(7.51±5.40),(5.79±5.18),(4.42±4.91)and (3.26±4.65)at 42 days,3,6,9,12 months later after childbirth,respectively. The differences in body weight retention at different times after childbirth indicated by repeated measures analysis of variance were statistical significant (P<0.001). Mixed-effects model analysis showed the postpartum sedentary behavior and postpartum body weight retention was statistically associated after adjusting for pre-pregnancy BMI,feeding pattern,delivery mode and other confounding factors(P<0.001), Mixed-effects model analysis results tended to be stable after step by step adjustment for confounding factors. Conclusion The results of this study suggested that postpartum sedentary behavior is one of the important factors influencing postpartum weight retention.

Influence of sedentary behavior on weight retention among postpartum women within one year ;after childbirth / 中华流行病学杂志

Objective To identify the risk factors that affect the postpartum weight retention among women and provide evidence for the prevention of obesity and metabolic disorders due to childbirth. Methods The baseline data were collected from 1 220 postpartum women who had given childbirth 42 days ago in Hefei Maternal and Child Health Care Center,Anhui province. Their pre-pregnancy weight,weight gain during pregnancy and childbirth information were obtained from local maternal information management system,and the follow up for the women were conducted at 3,6,9,and 12 months after childbirth. The sedentary behaviors of the women were observed. The relationship between postpartum weight retention and sedentary behavior of the women were analyzed by mixed-effects model analysis and repeated measures analysis of variance. Results The pre-pregnancy average body weight(kg)of the women was(53.22 ± 6.88),and their postpartum average body weight retention was(7.85±5.11),(7.51±5.40),(5.79±5.18),(4.42±4.91)and (3.26±4.65)at 42 days,3,6,9,12 months later after childbirth,respectively. The differences in body weight retention at different times after childbirth indicated by repeated measures analysis of variance were statistical significant (P<0.001). Mixed-effects model analysis showed the postpartum sedentary behavior and postpartum body weight retention was statistically associated after adjusting for pre-pregnancy BMI,feeding pattern,delivery mode and other confounding factors(P<0.001), Mixed-effects model analysis results tended to be stable after step by step adjustment for confounding factors. Conclusion The results of this study suggested that postpartum sedentary behavior is one of the important factors influencing postpartum weight retention.

Influence of physical activity on postpartum weight retention among women, one year after childbirth / 中华流行病学杂志

Objective To explore the risk factors affecting the postpartum weight retention among women.Methods Six hundred eight postpartum women were involved to establish a baseline at 42 days of postpartum in Hefei Maternal and Child Health Center of Anhui province.Information regarding pre-pregnancy weight and weight gain during pregnancy and childbirth were obtained from the Maternal Information Management System.Results Women that under study were followed up at 3,6,9,and 12 months after childbirth,with 502,476,469 and 434 available copies of valid data,respectively.Indicators of physical activity were observed.Relationship between postpartum weight retention and physical activities were analyzed by mixed-effect model,together with repeated measure-analysis on related variances.The pre-pregnancy average weight of the study objects was (54.26 ± 8.11) kg,with postpartum average weight retention as (7.83 ± 5.12),(6.58 ± 5.21),(5.10 ± 5.19),(4.07 ±+ 4.96) and (3.43 ±+ 4.98) kg in 42 days,3,6,9,12 months,respectively.Rates of weight retention was significantly different at different times of repeated measures analysis on variance (P＜0.001).Physical activities were also significantly different at different time spans (P＜ 0.001).Results from the mixed-effects model showed that physical activity and postpartum weight retention were statistically associated when adjustments were made on factors as:pre-pregnancy BMI,ways of feeding,mode of delivery and other confounders (P＜0.001) while results from the mixed-effects model showed that these data were stable from step adjustment on confounding factors.Conclusion It seemed that the strength of physical activity play an important role on postpartum weight retention.