Weight Loss, Gain, or Stability from 6 Weeks to 6 Months Postpartum: Associations with Depressive Symptoms and Behavioral Habits.

Background: Studies examining postpartum retained weight referenced to prepregnant body weight may mask weight gained after 6 weeks postpartum, a potential unrecognized factor contributing to weight increases after pregnancy. Materials and Methods: Using data from a longitudinal study, we examined three weight patterns from 6 weeks to 6 months postpartum (>2.3 kg gain; >2.3 kg loss; and ±2.3 kg as stable weight) in 302 low-income women. Predictor variables included perinatal variables, health habits, and depression risk at 3 and 6 months postpartum. Results: Mean weight changes were weight-gain group: 5.77 kg, standard deviation (SD) = 2.57; weight loss group: -4.79 kg, SD = 2.10; and stable group: 0.05 kg, SD = 1.24. The odds of gaining weight compared with stable weight increased with prepregnant overweight/obesity (adjusted odds ratio [aOR] = 3.22, 95% confidence interval [CI] = 1.74-6.00), and decreased with a first birth (aOR = 0.47, 95% CI = 0.24-0.93). The odds of losing weight increased with excessive gestational weight gain (aOR = 2.40, 95% CI = 1.10-5.21) and depression risk at 6 months (aOR = 2.57, 95% CI = 1.40-4.72), and decreased with prepregnant overweight/obesity (aOR = 0.49, 95% CI = 0.25-0.94). Health habits were not associated with weight gain or loss. Conclusions: Women with high body mass index (BMIs) may need added postpartum care to avoid gaining weight. Weight loss, although welcomed, may be secondary to depression risk. In both cases, low-cost, effective, and targeted care during the extended postpartum period could benefit women's health.

Development and evaluation of a mother-centered toolkit for postpartum behavioral and psychosocial health.

The well-being of mothers and infants is influenced by mothers' behavioral and psychosocial health (B&PH), yet it is often neglected during healthcare visits. To address this gap, this study aimed to develop and evaluate acceptability of a postpartum toolkit (screening questionnaire, feedback template, and decision aid) to promote B&PH. Using a decision-making model and participatory design (N = 24), a B&PH screening questionnaire was refined, and prototypes of feedback templates and decision aids for selecting health goals were developed. Most mothers in this multi-ethnic sample rated the resulting toolkit as easy to understand/use and useful, and reported they were likely to act on their health goals. Toolkit ease of use and usefulness ratings were largely unrelated to education, ethnicity, and acculturation. In conclusion, findings support the toolkit's acceptability and applicability to women of diverse backgrounds. The toolkit is a promising strategy to engage mothers in setting goals to promote B&PH.

e-Health and new moms: Contextual factors associated with sources of health information.

OBJECTIVE: Guided by the Uses and Gratifications approach, to examine mothers' use and preference of e-Health media, and associated contextual factors. DESIGN AND SAMPLE: Cross-sectional survey of 165 mothers (White, African-American, and Hispanic) from a stratified random sample. MEASURES: Use of online media about mother-baby care; favorite websites about motherhood and best-liked features of Web sites; channel preferences (Web site, postal mail, text) for receiving three types of health information; and contextual factors, e.g., education. RESULTS: Media use ranged from 96% for health information searches about babies to 46% for YouTube viewing about mother-baby topics. Contextual factors, such as education, were associated with media use. Babycenter was the most frequently reported favorite Web site and rich, relevant information was the best-liked feature. Across three health topics (weight, stress/depression, parenting) mothers preferred receiving information by Web site, followed by postal mail and least by text messaging (χ2 statistics, p < .001). Stress and race/ethnicity were among factors associated with preferences. CONCLUSIONS: Mothers widely used e-Health related media, but use was associated with contextual factors. In public health efforts to reach new mothers, partnering with mother-favored Web sites, focusing on audience-relevant media, and adopting attributes of successful sites are recommended strategies.

Behavioral and Psychosocial Health of New Mothers and Associations With Contextual Factors and Perceived Health.

OBJECTIVE: To test the association of behavioral and psychosocial health domains with contextual variables and perceived health in ethnically and economically diverse postpartum women. DESIGN: Mail survey of a stratified random sample. SETTING: Southwestern community in Texas. PARTICIPANTS: Non-Hispanic White, African American, and Hispanic women (N = 168). METHODS: A questionnaire was sent to a sample of 600 women. The adjusted response rate was 32.8%. The questionnaire covered behavioral (diet, physical activity, smoking, and alcohol use) and psychosocial (depression symptoms and body image) health, contextual variables (race/ethnicity, income, perceived stress, and social support), and perceived health. Hypotheses were tested using linear and logistic regression. RESULTS: Body image, dietary behaviors, physical activity behaviors, and depression symptoms were all significantly correlated (Spearman ρ = -.15 to .47). Higher income was associated with increased odds of higher alcohol use (more than 1 drink on 1 to 4 days in a 14-day period). African American ethnicity was correlated with less healthy dietary behaviors and Hispanic ethnicity with less physical activity. In multivariable regressions, perceived stress was associated with less healthy dietary behaviors, increased odds of depression, and decreased odds of higher alcohol use, whereas social support was associated with less body image dissatisfaction, more physical activity, and decreased odds of depression. All behavioral and psychosocial domains were significantly correlated with perceived health, with higher alcohol use related to more favorable perceived health. In regressions analyses, perceived stress was a significant contextual predictor of perceived health. CONCLUSION: Stress and social support had more consistent relationships to behavioral and psychosocial variables than race/ethnicity and income level.