A Longitudinal Cohort Study on Maternal Weight Change Preceding Pregnancy in Relation to Gestational Weight Gain, Pregnancy Outcome and Weight Retention

Van Der Wijden Carla L

doi:10.16966/2380-5528.110

Abstract

Objectives: To study the effect of weight changes before pregnancy on maternal weight development during and after pregnancy and on birth weight. Because physical activity, smoking, breastfeeding and sleeping might play a role in weight development, they were taken into account. Methods: In a longitudinal cohort study in 254 women, anthropometric measurements were performed at 15, 25, and 35 weeks of gestation and 6, 26 and 52 weeks postpartum. In addition, women reported on weight changes in the six months preceding pregnancy, and on smoking, sleeping, and breastfeeding. Physical activity and sedentary behaviour were measured objectively using accelerometers. Of 217 babies birth weight and birth percentile were reported. In linear regression models, the relation between weight changes before pregnancy with gestational weight gain, pregnancy outcome and weight retention was assessed, controlling for lifestyle factors. Results: About 9% of all women lost more than 5% of body weight before pregnancy, and another 6% gained more than 5% of body weight. Women who lost weight had a significantly higher BMI throughout pregnancy and the postpartum period compared to women with a more stable weight. After adjusting for BMI at 15 weeks, age, and lifestyle factors, women who lost weight had significantly more weight retention (beta 3.64 kg, 95% CI 0.57 to 6.70 kg) and delivered heavier babies (beta 391.5 g, 95% CI 106.3 to 676.7 g). Conclusions: Maternal body weight change preceding pregnancy influenced birth weight and maternal weight retention. These findings should be confirmed in a much larger sample.

Highlights

Pregnancy is considered to be an important period for the development of subsequent maternal overweight and obesity, or worsening already existing overweight [1,2].Guidelines on gestational weight gain exist [2], in which the importance of a normal weight before pregnancy and weight gain within certain limits during pregnancy is emphasized
Althuizen et al [5] showed that the overall weight retention at one year postpartum was 0.9 kg and 20% retained ≥ 5 kg
The intervention did not have an effect on gestational weight gain, weight retention [5] and physical activity

Summary

Introduction

Pregnancy is considered to be an important period for the development of subsequent maternal overweight and obesity, or worsening already existing overweight [1,2].Guidelines on gestational weight gain exist [2], in which the importance of a normal weight before pregnancy and weight gain within certain limits during pregnancy is emphasized. Pregnancy is considered to be an important period for the development of subsequent maternal overweight and obesity, or worsening already existing overweight [1,2]. Many women do not gain weight according to these guidelines [4]. There are a growing number of trials, studying the effect of dietary and physical activity interventions on the prevention of excessive weight gain during pregnancy. According to a recent review, the effect of these interventions on weight gain is moderate to very small and maternal and neonatal morbidity were not always taken into account [6]. Most intervention studies had a short follow up, making it difficult to assess the role of intervention effects on maternal weight development in the long term. Based on the findings of this review gestational weight gain seems to be difficult to influence in pregnancy

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