Abstract
BackgroundLong-term obesity after pregnancy is associated with obesity prior to pregnancy and retention of weight postpartum. This study aims to identify socioeconomic differences in prepregnancy body mass index, quantify the impact of prepregnancy obesity on birth outcomes, and identify determinants of postpartum weight retention.MethodsA total of 2231 pregnant women, recruited from three public hospitals in Southeast Queensland in Australia during antenatal clinic visits, completed a questionnaire to elicit information on demographics, socioeconomic and behavioural characteristics. Perinatal information was extracted from hospital records. A follow-up questionnaire was completed by each participant at 12 months after the birth to obtain the mother’s postpartum weight, breastfeeding pattern, dietary and physical activity characteristics, and the child’s health and development information. Multivariate logistic regression method was used to model the association between prepregnancy obesity and outcomes.ResultsBeing overweight or obese prepregnancy was strongly associated with socioeconomic status and adverse behavioural factors. Obese women (18% of the cohort) were more likely to experience gestational diabetes, preeclampsia, cesarean delivery, and their children were more likely to experience intensive- or special-care nursery admission, fetal distress, resuscitation, and macrosomia. Women were more likely to retain weight postpartum if they consumed three or fewer serves of fruit/vegetables per day, did not engage in recreational activity with their baby, spent less than once a week on walking for 30 minutes or more or spent time with friends less than once per week. Mothers who breastfed for more than 3 months had reduced likelihood of high postpartum weight retention.ConclusionsFindings provide additional specificity to the increasing evidence of the predisposition of obesity prepregnancy on adverse maternal and perinatal outcomes. They may be used to target effective behavioural change interventions to address obesity in women.
Highlights
Long-term obesity after pregnancy is associated with obesity prior to pregnancy and retention of weight postpartum
The aims of this study were to identify any socioeconomic differential in prepregnancy body mass index (BMI), to quantify the impact of prepregnancy obesity on maternal and neonatal outcomes, and to identify determinants that are associated with postpartum weight retention
Sample characteristics Baseline characteristics of the Environments for Healthy Living (EFHL) cohort are displayed in Table 1 along with corresponding details of births with gestation of 28 weeks or more in the study region between 2007–2010
Summary
Long-term obesity after pregnancy is associated with obesity prior to pregnancy and retention of weight postpartum. Pregnant women who are overweight or obese have a disproportionate risk of induced preterm delivery [5] and maternal, intrapartum, peripartum, neonatal [6,7], and postpartum complications including gestational diabetes mellitus (GDM), type 2 diabetes, high blood pressure, dyslipidaemia, cardiovascular disease and several major cancers [7,8]. The offspring of these women have a significantly elevated risk of adverse short- and long-term health issues [9,10,11]. Children of women with GDM are more likely to be obese and have impaired glucose tolerance and diabetes in childhood and adulthood [12,13]
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