Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-26T17:54:28.488Z Has data issue: false hasContentIssue false
  • English
  • Français

Nine months postpartum weight retention predictors for Brazilian women

Published online by Cambridge University Press:  02 January 2007

Gilberto Kac ,
Maria HDA Benicio ,
Gustavo Velásquez-Meléndez  and
Joaquim G Valente
Gilberto Kac*
Affiliation:
Department of Social and Applied Nutrition, Institute of Nutrition, Federal University of Rio de Janeiro, Av. Brigadeiro Trompowsky s/n° – Bloco J – 2° andar, Rio de Janeiro, RJ 21941–590, Brazil
Maria HDA Benicio
Affiliation:
Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
Gustavo Velásquez-Meléndez
Affiliation:
Department of Maternal and Pediatric Nursing and Public Health, School of Nursing, Federal University de Minas Gerais, Belo Horizonte, MG, Brazil
Joaquim G Valente
Affiliation:
Department of Epidemiology and Quantitative Methods in Health, National School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
*
*Corresponding author: Email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

To identify factors potentially associated with weight retention measured 9 months after childbirth.

Design:

Prospective study with four follow-up waves in time (0.5, 2, 6 and 9 months postpartum).

Setting:

Rio de Janeiro, Brazil.

Subjects and methods:

Two hundred and sixty-six Brazilian women of childbearing age. Analysis was based on hierarchical logistic regression. The dependent variable was weight retention and was defined as the difference between weight at 9 months postpartum and pre-pregnancy weight, with a dichotomised cut-off at 7.5 kg. Covariates included demographic and socio-economic data, obstetric history, anthropometric data, and data on the infant. These data were grouped in blocks and ordered according to their influence on the dependent variable.

Results:

Of the women studied, 19.2% presented weight retention values ≥7.5 kg. According to the logistic regression analysis, the following variables remained associated with weight retention ≥7.5 kg: total family income, difficulty or inability to read a letter, age category ≥30 years, age at first childbirth <23 years, gestational weight gain ≥12 kg, body fat at baseline ≥30% and infant birth weight <3500 g. Infant hospitalisation was only marginally significant.

Conclusions:

Determinant factors identified by the analysis highlight the need for nutritional intervention policies during pregnancy and in the first months postpartum as a way of minimising obesity and the diseases resulting from it.

Keywords

Postpartum weight retentionObesityGestational weight gainHierarchical models
Type
Research Article
Information
Public Health Nutrition , Volume 7 , Issue 5 , August 2004 , pp. 621 - 628
Copyright
Copyright © The Authors 2004

References

1World Health Organization (WHO). Obesity: Preventing and Managing the Global Epidemic. WHO Technical Report Series No. 894. Geneva: WHO 1998.Google Scholar
2Flegal, KM, Carroll, MD, Kuczmarski, RJ, Johnson, CL. Overweight and obesity in the United States: prevalence and trends, 1960–1994. International Journal of Obesity and Related Metabolic Disorders 1998; 22: 39–47.CrossRefGoogle ScholarPubMed
3Monteiro, CA. Epidemiologia da obesidade. In: Halpern, A, Matos, AFG, Suplicy, HL, Mancini, MC, Zanella, MT, eds. Obesidade. Porto Alegre: Lemos Editorial, 1999; 15–30.Google Scholar
4Hidalgo, CAG, Kac, G, Velásquez-Meléndez, G. Valente, JG. Factors associated with overweight in Brazilian childbearing-age women according to skin colour. Nutrition Research 2002; 42: 785–94.CrossRefGoogle Scholar
5Mansur, AP, Gomes, EP, Avakian, SD, Favarato, D, Cesar, LA, Mendes-Aldrighi, J, et al. Clustering of traditional risk factors and precocity of coronary disease in women. International Journal of Cardiology 2001; 81: 205–9.CrossRefGoogle ScholarPubMed
6Visscher, TL, Seidell, JC. The public health impact of obesity. Annual Review of Public Health 2001; 22: 355–75.CrossRefGoogle ScholarPubMed
7Kac, G. Fatores determinantes da retenção de peso: uma revisão da literatura. Cadernos de Saude Publica 2001; 17: 455–66.CrossRefGoogle Scholar
8Gunderson, EP, Abrams, B. Epidemiology of gestational weight gain and body weight changes after pregnancy. Epidemiologic Reviews 1999; 21: 261–75.CrossRefGoogle Scholar
9Linne, Y, Barkeling, B, Rossner, S. Long term weight development after pregnancy. Obesity Reviews 2002; 3: 75–31.CrossRefGoogle Scholar
10Keppel, KG, Taffel, SM. Pregnancy-related weight gain and retention: implications of the 1990 Institute of Medicine guidelines. American Journal of Public Health 1993; 83: 1100–31.CrossRefGoogle ScholarPubMed
11Lederman, SA. The effect of pregnancy weight gain on later obesity. Obstetrics and Gynecology 1993; 82: 148–31.Google ScholarPubMed
12Muscati, SK, Gray-Donald, K, Koski, KG. Timing of weight gain during pregnancy: promoting fetal growth and minimizing maternal weight retention. International Journal of Obesity and Related Metabolic Disorders 1996; 20: 526–31.Google ScholarPubMed
13Abrams, B, Selvim, S, Gunderson, EP. Pregnancy weight gain: still controversial. American Journal of Clinical Nutrition 2000; 71(Suppl.): 1233S–41S.CrossRefGoogle ScholarPubMed
14Coitinho, DC, Sichieri, R, Benicio, MHDA. Obesity and weight change related to parity and breast-feeding among parous women in Brazil. Public Health Nutrition 2001; 4: 865–31.CrossRefGoogle ScholarPubMed
15Janney, CA, Zhang, D, Sowers, M. Lactation and weight retention. American Journal of Clinical Nutrition 1997; 66: 1116–31.CrossRefGoogle ScholarPubMed
16Butte, NF, Hopkinson, JM. Body composition changes during lactation are highly variable among women. Journal of Nutrition 1998; 128(Suppl. 2): 381S–5S.CrossRefGoogle ScholarPubMed
17Kac, G, Benício, MHDA, Velásquez-Meléndez, G, Valente, JG, Struchiner, CJ. Breastfeeding and postpartum weight retention in a cohort of Brazilian women. American Journal of Clinical Nutrition 2003; in pressGoogle Scholar
18Lovelady, CA, Garner, KE, Moreno, KL, Williams, JP. The effect of weight loss in overweight, lactating women on the growth of their infants. New England Journal of Medicine 2000; 342: 449–31.CrossRefGoogle ScholarPubMed
19Lohman, TG, Roche, AF, Martorell, R. Anthropometric Standardization Reference Manual. Champaign, IL: Human Kinetics Books, 1988.Google Scholar
20Hosmer, DM, Lemeshow, S. Applied Logistic Regression, 2nd ed. New York: John Wiley 1989.Google Scholar
21Victora, CG, Huttly, SR, Fuchs, SC, Olinto, MTA. The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. International Journal of Epidemiology 1997; 26: 224–31.CrossRefGoogle ScholarPubMed
22Monteiro, CA, Conde, WL. A tendência secular da obesidade segundo estratos sociais: Nordeste e Sudeste do Brasil, 1975–1989–1995. Arquivos Brasileiros de Endocrinologia e Metabologia 1999; 43: 186–31.CrossRefGoogle Scholar
23Monteiro, CA, Benício, MHDA, Conde, WL, Popkin, BM. Shifting obesity trends in Brazil. European Journal of Clinical Nutrition 2000; 54: 1–31.CrossRefGoogle ScholarPubMed
24Sobal, J, Stunkard, A. Socioeconomic status and obesity: a review of the literature. Psychological Bulletin 1989; 105: 260–31.CrossRefGoogle ScholarPubMed
25Monteiro, CA, Conde, WL, Popkin, BM. Independent effects of income and education on the risk of obesity in the Brazilian adult population. Journal of Nutrition 2001; 131: 881S–6S.CrossRefGoogle ScholarPubMed
26Martorell, R, Khan, LK, Hughes, ML, Grummer-Strawn, CM. Obesity in women from developing countries. European Journal of Clinical Nutrition 2000; 54: 246–31.CrossRefGoogle ScholarPubMed
27Parker, JD, Abrams, B. Differences in postpartum weight retention between black and white mothers. Obstetrics and Gynecology 1993; 81: 768–31.Google ScholarPubMed
28Lederman, SA, Alfasi, G, Deckelbaum, RJ. Pregnancy-associated obesity in black women in New York City. Maternal and Child Health Journal 2002; 1: 37–42.CrossRefGoogle Scholar
29Kac, G, Velásquez-Meléndez, G, Valente, JG. Menarca, gravidez precoce e obesidade em mulheres Brasileiras selecionadas em um Centro de Saúde de Belo Horizonte. Cadernos de Saude Publica 2003; 19(Suppl. 1): S111–8.CrossRefGoogle Scholar
30Lovejoy, JC. The influence of sex hormones on obesity across the female life span. Journal of Women's Health 1998; 7: 1247–56.CrossRefGoogle ScholarPubMed
31Gunderson, EP, Abrams, B, Selvin, S. The relative importance of gestational gain and maternal characteristics associated with the risk of becoming overweight after pregnancy. International Journal of Obesity and Related Metabolic Disorders 2000; 24: 1660–8.CrossRefGoogle Scholar
32Ohlin, A, Rossner, S. Maternal body weight development after pregnancy. International Journal of Obesity 1990; 14: 159–73.Google Scholar
33Lederman, SA. Pregnancy weight gain and postpartum loss: avoiding obesity while optimizing the growth and development of the fetus. Journal of the American Medical Women's Association 2001; 56: 53–8.Google ScholarPubMed
34Nucci, LB, Duncan, BB, Mengue, SS, Branchtein, L, Schmidt, MI, Fleck, ET. Assessment of weight gain during pregnancy in general prenatal care services in Brazil. Cadernos de Saude Publica 2001; 17: 1367–74.CrossRefGoogle Scholar
35Stewart, A, Jackson, R, Ford, M, Beaglehole, R. Underestimation of relative weight by use of self-reported height and weight. American Journal of Epidemiology 1987; 125: 122–6.CrossRefGoogle ScholarPubMed
36Schmidt, MI, Duncan, BB, Tavares, M, Polanczyk, CA, Pellanda, L, Zimmer, PM. Validity of self-reported weight – a study of urban Brazilian adults. Revista de Saude Publica 1993; 27: 271–6.CrossRefGoogle Scholar
37Lederman, SA, Paxton, A. Maternal reporting of prepregnancy weight and birth outcome: consistency and completeness compared with clinical record. Maternal and Child Health Journal 1998; 2: 123–6.CrossRefGoogle ScholarPubMed
38Chor, D, Coutinho, ESF, Laurenti, R. Reliability and self-reported weight and height among state bank employees. Revista de Saude Publica 1999; 33: 16–23.CrossRefGoogle ScholarPubMed
39Institute of Medicine, Subcommittee on Nutritional Status and Weight Gain during Pregnancy. Nutrition During Pregnancy. Washington, DC: National Academy of Sciences, 1990.Google Scholar
40Dewey, KG. 1998; Effects of maternal caloric restriction and exercise during lactation. Journal of Nutrition 1998; 128: 386S–9S.CrossRefGoogle ScholarPubMed