Abstract

Women with excessive gestational weight gain are at increased risk of postpartum weight retention and potentially also unfavorable body composition. Insight into the lifestyle behaviors that play a role in the evolution of postpartum weight and body composition among these women could aid identification of those at highest risk of long-term adverse outcomes. This secondary analysis of the INTER-ACT randomized controlled trial investigates control group data only (n = 524). The evolution of weight retention, percentage loss of gestational weight gain, fat percentage, waist circumference, and associated lifestyle behaviors between 6 weeks and 12 months postpartum were assessed using mixed model analyses. At six weeks postpartum, every sedentary hour was associated with 0.1% higher fat percentage (P = 0.01), and a higher emotional eating score was associated with 0.2% higher fat percentage (P < 0.001) and 0.3 cm higher waist circumference (P < 0.001). Increase in emotional eating score between 6 weeks and 6 months postpartum was associated with a 0.4 kg (P = 0.003) increase in postpartum weight retention from six months onwards. Among women with overweight, an increase in the uncontrolled eating score between 6 weeks and 6 months postpartum was associated with a 0.3 kg higher postpartum weight retention (P = 0.04), and 0.3% higher fat percentage (P = 0.006) from six months onwards. In conclusion, sedentary and eating behaviors play important roles in postpartum weight and body composition of women with excessive gestational weight gain and should therefore be incorporated as focal points in lifestyle interventions for this population.

Highlights

  • The retention of pregnancy weight after delivery contributes to long-term overweight and associated morbidities such as cardiovascular diseases, type 2 diabetes mellitus and certain cancer types [1,2,3,4]

  • This study described postpartum weight retention (PPWR), % GWGL, fat percentage and waist circumference evolution in the first year after delivery among women with preceding excessive gestational weight gain (GWG) and revealed how these evolutions were different according to pre-pregnancy body mass index (BMI), amount of excessive GWG, and sex of the infant

  • In terms of lifestyle behaviors, sedentary time was associated with fat percentage, emotional eating with all outcomes, and uncontrolled eating with all outcomes except waist circumference

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Summary

Introduction

The retention of pregnancy weight after delivery contributes to long-term overweight and associated morbidities such as cardiovascular diseases, type 2 diabetes mellitus and certain cancer types [1,2,3,4]. 75% of women do not return to their pre-pregnancy weight in the year following delivery [1]. Studies show a mean postpartum weight retention (PPWR). An important risk factor for PPWR is excessive gestational weight gain (GWG) [5,6], which occurs in approximately 35% to. Women with an excessive GWG were previously found to have a three kilogram higher PPWR three years after delivery compared to women who had an adequate GWG [9].

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