Does the relationship between parity and overweight vary with household wealth and country development?

Abstract

Does having children contribute to obesity in developing countries through post-partum weight retention? Recent studies support this relationship; yet, it is unclear whether these effects vary by household and country wealth. The present analysis, carried out at the individual level, involved 275,704 women aged 15–49 y from 28 Demographic and Health Surveys. We classified women by tertile of country development (CD), which we based on an index of demographic, economic, and health indicators. Household wealth was defined by an index of assets and household conditions. Using logistic regression, we tested whether the parity-overweight relationship varied by tertile of household (HH) wealth, within each tertile of CD. We found a negative relationship between parity and overweight among the poorest women but only in the lowest and middle CD tertiles. Among the wealthiest women, parity was positively related to overweight at all levels of CD, with a 2–3 fold difference in the odds of overweight for parity-4+ vs. parity-0. Results are consistent with the idea that having children is depleting among poor women in poor countries but leads to overweight among wealthy women regardless of country characteristics. Funding: NIH R01 TW005598