255-OR: Postpartum Weight Retention and the Early Evolution of Cardiovascular Risk over the First 5 Years after Delivery

Abstract

The cumulative effect of postpartum weight retention from each pregnancy in a woman’s life may contribute to her risk of ultimately developing cardiovascular (CV) disease and type 2 diabetes. However, there is limited direct evidence supporting this hypothesis. Thus, we sought to characterize the impact of postpartum weight retention on the trajectories of cardiometabolic risk factors over the first 5 years after pregnancy. Three-hundred-and-thirty women underwent cardiometabolic characterization in pregnancy and at 3-months, 1-yr, 3-yr, and 5-yrs postpartum. They were stratified into 3 groups based on the magnitude of weight change between pre-pregnancy and 5-yrs postpartum as follows: weight gain <0% (n=100), weight gain 0-6% (n=110), and weight gain >6% (n=120). CV risk factors did not differ between these groups at 1-yr postpartum but showed a stepwise worsening across the groups at 3- and 5-yrs (Fig). Specifically, adverse lipids, insulin resistance, and CRP progressively worsened from the weight gain <0% group to weight gain 0-6% to weight gain >6% (all p<0.05). On logistic regression analyses of prediabetes/diabetes at 5-years postpartum, weight gain >6% was shown to be significant (adjusted OR 3.40 [1.63 to 7.09]). In conclusion, postpartum weight retention predicts trajectories of enhanced CV risk and rising glycemia over the first 5-yrs after delivery. Disclosure C.K. Kramer: Research Support; Boehringer Ingelheim Inc. C. Ye: None. A. Hanley: None. P.W. Connelly: None. B. Zinman: Consultant; Abbott Diabetes, Eli Lilly and Company, Novo Nordisk A/S, Novo Nordisk Canada Inc., Boehringer Ingelheim Inc., Merck & Co., Inc. R. Retnakaran: Research Support; Boehringer Ingelheim/Mount Sinai Hospital, Novo Nordisk. Other Relationship; Sanofi, Eli Lilly and Company.