Postpartum Weight Research Articles

Dietary treatment postpartum in women with obesity reduces weight and prevents weight gain: a randomised controlled trial

BackgroundWomen with pre-pregnancy obesity have an increased risk of retaining or gaining weight postpartum and may benefit from weight loss treatment. However, evidence is lacking for weight loss strategies in women with BMIs in the higher obesity classes. A dietary treatment for postpartum weight loss resulted in a 10% weight reduction in lactating women with a mean BMI of 30 kg/m2. We aimed to examine the effects of this dietary treatment on changes in weight, markers of lipid and glucose metabolism, waist and hip circumference and postpartum weight retention (PPWR) in postpartum women with higher BMIs than tested previously.MethodsAt baseline, approximately 8 weeks postpartum, 29 women with a mean (SD) BMI = 40.0 (5.2) kg/m2 were randomised to a 12-week dietary treatment (n 14) or to a control treatment (n 15). Measurements were made at baseline and after 3 and 12 months. Data was analysed using mixed model.ResultsThe mean weight change in the diet group was -2.3 (3.1) kg compared to 1.7 (3.1) kg in the control group after 3 months (P = 0.003) and -4.2 (5.6) kg compared to 4.8 (11.8) kg in the control group after 12 months (P = 0.02). The dietary treatment led to reduced waist circumference (P < 0.04) and PPWR (P < 0.01) compared to the control treatment at both time points. The treatment lowered fasting blood glucose at 12 months (P = 0.007) as the only effect on markers of lipid and glucose metabolism.ConclusionThe dietary treatment postpartum reduced weight and prevented weight retention or weight gain in women with obesity.Trial registrationThe trial was retrospectively registered at ClinicalTrials.gov (NCT03579667) 06/07/2018.Graphical In a randomised, controlled trial, 29 postpartum women with obesity were allocated to a dietary treatment or a control treatment. The dietary treatment reduced weight and prevented postpartum weight retention or weight gain after 12 months.Reference: Adapted from “Randomized, Placebo-Controlled, Parallel Study Design (2 Arms, Graphical)”, by BioRender.com (2022). Retrieved from https://app.biorender.com/biorender-templates.

A Complex mHealth Coaching Intervention to Prevent Overweight, Obesity, and Diabetes in High-Risk Women in Antenatal Care: Protocol for a Hybrid Type 2 Effectiveness-Implementation Study.

Women with overweight and obesity are at higher risk of developing complications in pregnancy such as gestational diabetes and longer-term chronic conditions. Research concerning health behavior change interventions during pregnancy and postpartum shows promising effects, but implementation into routine services is sparsely investigated. Most interventions focus on the antenatal or postpartum life stages, failing to meet the needs of women. IMPACT DIABETES Bump2Baby is a multicenter project across 4 high-income countries developed to test the implementation of an antenatal and postpartum evidence-based mobile health (mHealth) coaching intervention called Bump2Baby and Me (B2B&Me) designed to sit alongside usual care in the perinatal period. We aim to explore the feasibility and implementation of the B2B&Me intervention and investigate the effectiveness of this intervention in women at risk of gestational diabetes. IMPACT DIABETES Bump2Baby is a hybrid type 2 effectiveness-implementation study, which integrates an evidence-based mHealth coaching app that includes personalized health behavior change coaching provided by health care professionals alongside antenatal care from the first antenatal visit to 12 months postpartum. The mHealth app offers the possibility of synchronous calls, asynchronous contact (including coach-participant text and video messaging exchanges tailored to the participant's needs), and ongoing access to an extensive library of bespoke intervention materials. Participants will interact asynchronously with their health coach throughout the intervention via the app. This randomized controlled trial across 4 clinical sites within Ireland, the United Kingdom, Spain, and Australia will recruit 800 women in early pregnancy to evaluate the effectiveness on postpartum weight. The Exploration, Preparation, Implementation, and Sustainment implementation framework is the theoretical underpinning of the study. The implementation evaluation will be assessed at the individual, hospital staff, and broader community levels using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. Data sources for the RE-AIM evaluation will include app and platform analytics, screening and training records, participant medical records, key informant interviews, participant and partner exit interviews, cost data, study questionnaires, staff surveys, and blood sample analyses. The study was approved and registered with the Australian New Zealand Clinical Trials Registry on November 19, 2020. Recruitment commenced on February 9, 2021, and data collection is ongoing. Publication of the results is expected in 2024. This is the first hybrid effectiveness-implementation study of an 18-month mHealth coaching intervention in at-risk women that we are aware of. As research aims to move toward real-world implementable solutions, it is critical that hybrid studies are conducted. The data from this large multicenter study will be useful in planning the potential implementation and scale-up of evidence-based perinatal health behavior change interventions. Australian New Zealand Clinical Trials Registry ACTRN12620001240932; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380020&isReview=true. DERR1-10.2196/51431.

Per- and polyfluoroalkyl substances, gestational weight gain, postpartum weight retention and body composition in the UPSIDE cohort

BackgroundPer- and polyfluoroalkyl substances (PFAS) are synthetic chemicals found in drinking water and consumer products, resulting in ubiquitous human exposure. PFAS have been linked to endocrine disruption and altered weight gain across the lifespan. A limited and inconsistent body of research suggests PFAS may impact gestational weight gain (GWG) and postpartum body mass index (BMI), which are important predictors of overall infant and maternal health, respectively.MethodsIn the Understanding Pregnancy Signals and Infant Development (UPSIDE/UPSIDE-MOMs) study (n = 243; Rochester, NY), we examined second trimester serum PFAS (PFOS: perfluorooctanesulfonic acid, PFOA: perfluorooctanoic acid, PFNA: perfluorononanoic acid, PFHxS: perfluorohexanesulfonic acid, PFDA: perfluorodecanoic acid) in relation to GWG (kg, and weekly rate of gain) and in the postpartum, weight retention (PPWR (kg) and total body fat percentage (measured by bioelectrical impedance)). We fit multivariable linear regression models examining these outcomes in relation to log-transformed PFAS in the whole cohort as well as stratified by maternal pre-pregnancy BMI (< 25 vs. = > 25 kg/m2), adjusting for demographics and lifestyle factors. We used weighted quantile sum regression to find the combined influence of the 5 PFAS on GWG, PPWR, and body fat percentage.ResultsPFOA and PFHxS were inversely associated with total GWG (PFOA: ß = -1.54 kg, 95%CI: -2.79, -0.30; rate ß = -0.05 kg/week, 95%CI: -0.09, -0.01; PFHxS: ß = -1.59 kg, 95%CI: -3.39, 0.21; rate ß = -0.05 kg/week, 95%CI: -0.11, 0.01) and PPWR at 6 and 12 months (PFOA 6 months: ß = -2.39 kg, 95%CI: -4.17, -0.61; 12 months: ß = -4.02 kg, 95%CI: -6.58, -1.46; PFHxS 6 months: ß = -2.94 kg, 95%CI: -5.52, -0.35; 12 months: ß = -5.13 kg, 95%CI: -8.34, -1.93). PFOA was additionally associated with lower body fat percentage at 6 and 12 months (ß = -1.75, 95%CI: -3.17, -0.32; ß = -1.64, 95%CI: -3.43, 0.16, respectively) with stronger associations observed in participants with higher pre-pregnancy BMI. The PFAS mixture was inversely associated with weight retention at 12 months (ß = -2.030, 95%CI: -3.486, -0.573) amongst all participants.ConclusionPFAS, in particular PFOA and PFHxS, in pregnancy are associated with altered patterns of GWG and postpartum adiposity with potential implications for fetal development and long-term maternal cardiometabolic health.

Reproductive performance and productivity of local and Dorper x local crossbred ewes under community-based management system, Ethiopia

This study evaluated the reproductive and productivity of local and Dorper crossbred ewes in a community-based management system. We analyzed data collected from 2013 to 2021, taking into account different factors such as dam-breed, location, type of birth, season, and year of lambing. Lambing was observed all year-round, but the majority (35%) occurred in September, October, and December. This suggests that pasture availability, which is influenced by climatic-factors, may play a role in the seasonality of lambing. Litter-size at birth and weaning did not show any significant difference. Age at first lambing varied between breeds (P < 0.001), while lambing-interval and annual reproductive rates were unaffected by dam-breed (P > 0.05). The annual number of lambing per year significantly varied based on location and lambing seasons (P < 0.001), with a higher frequency during the major rainy-season compared to the dry-season (1.58vs1.42), highlighting the influence of feed availability. Productivity indices of ewes were calculated. Location and season of lambing had a significant impact on annual ewe productivity, while the ewe genotype showed no significant influence on productivity indices, except for the weight of lambs produced per kilogram of metabolic weight (0.84vs0.72 lambs per kg ewe and year; P < 0.01: 2.02vs1.77 kg lamb per kg0.75 ewe and year), where local ewes outperformed Dorper crossbred ewes. The difference in annual-productivity indices between local and Dorper crossbred ewes was more evident when considering the postpartum weight, as the ewes exhibited higher postpartum weights. However, both ewe genotypes produced comparable lamb weights per year (20.91vs20.16 kg lamb weaned per ewe and year for local and Dorper crossbred ewes, respectively). In summary, under low-input conditions, Dorper crossbred ewes demonstrated comparable reproductive performances and productivity traits to local ewes. Nevertheless, breed and environmental factors identified in this study should be taken into account to enhance sheep productivity in both local and Dorper crossbred ewes.

Are Habitual Levels Or Changes In Accelerometer Measured Physical Activity Associated With Postpartum Weight Loss?

Are Habitual Levels Or Changes In Accelerometer Measured Physical Activity Associated With Postpartum Weight Loss?

Risk Factors that Increase Maternal Morbidity in Pregnant Women Between 30 to 34 Years of Age

Introduction. According to the World Health Organization (WHO), the prevalence of obesity worldwide has nearly tripled since 1975. According to 2016 data, 39% of the global adult population was overweight, and 13% was obese. A recent study, including 20 European countries, concluded that 53% of adults were overweight or obese. Increase in overweight and obesity among women of childbearing age (15 to 44 years). Overweight and obesity during pregnancy are associated with many complications, including increased risk of gestational hypertension, preeclampsia, gestational diabetes mellitus, cesarean delivery, preterm delivery, large-for-gestational-age infants, and stillbirths. Additionally, gestational weight gain is associated with diabetes, pregnancy-induced hypertension, cesarean delivery, postpartum weight retention, macrosomia, and childhood obesity. Materials and Methods. An observational, cross-sectional study in 15 pregnant women in 2022 at the Playa del Carmen General Hospital. Results. Were completed variables of interest in prenatal control. Discussion. The short interval between pregnancies is a public health problem because it leads to adverse perinatal outcomes such as postpartum hemorrhage, anemia, preterm delivery, low birth weight, and perinatal deaths. Ineffective or no contraception after one pregnancy contributes to a subsequent pregnancy. Conclusion. It is essential to detect gestational Diabetes mellitus as well as gestational hypertension, and prenatal control should be improved because although pregnant women report carrying it out, it is not reflected in cases of preeclampsia that remains high in pregnant women.

Burden of excessive gestational weight gain and postpartum weight retention among Indian women - A systematic review and meta-analysis

BackgroundExcessive weight gain during pregnancy and weight retention in the postpartum period may lead to obesity, diabetes mellitus, and cardiovascular events among women in later life, as well as adverse perinatal outcomes, and long-term offspring health outcomes during the current and subsequent pregnancies. However, most studies of gestational weight gain (GWG) and postpartum weight retention (PPWR) are in western and developed countries. Therefore, this paper aimed to determine the burden of gestational weight gain and postpartum weight retention among Indian women. Materials & methodsThree electronic database- Medline, Google Scholar, and Cochrane library were searched for studies up until March 31, 2022. Studies on GWG and PPWR from India were included in the review. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) checklist was used for reporting the current review. Online platform Rayyan was used to screen and select the studies. Data were extracted from the 13 selected articles and pooled estimates, proportion and mean of GWG & PPWR along with 95% CI were estimated. ResultsOverall 271 articles were identified after the initial search and 13 articles were included (n = 6656) in the review. Nine studies reported proportion of women with excessive GWG, seven studies reported mean GWG and three studies described weight retention among postpartum mothers. The pooled proportion of Indian pregnant women with excessive GWG was found to be 16.48% (95% CI: 11.52, 21.43) and the pooled mean of GWG was 10.08 kg (95% CI: 7.81–12.34). The highest pooled proportion of women with excessive GWG was reported in the North region with 22.57% and the lowest in the East region with 9.15%. The highest pooled mean of GWG was reported in the East region with 12.90 kg and the lowest in the North region with 6.40 kg. Findings from three studies were systematically reviewed and summarized for postpartum weight retention among Indian women. ConclusionAlthough majority of Indian women achieved GWG less than the recommendations, there is a need for larger population based surveys among Indian women to obtain adequate, appropriate and complete health related information about weight changes during and after pregnancy.

Examining demographic and psychosocial factors related to self-weighing behavior during pregnancy and postpartum periods

Black childbearing individuals in the US experience a higher risk of postpartum weight retention (PPWR) compared to their White counterparts. Given that PPWR is related to adverse health outcomes, it is important to investigate predictors of weight-related health behaviors, such as self-weighing (i.e., using a scale at home). Regular self-weighing is an evidence-based weight management strategy, but there is minimal insight into sociodemographic factors related to frequency. The Postpartum Mothers Mobile Study (PMOMS) facilitated longitudinal ambulatory weight assessments to investigate racial inequities in PPWR. Our objective for the present study was to describe self-weighing behavior during and after pregnancy in the PMOMS cohort, as well as related demographic and psychosocial factors. Applying tree modeling and multiple regression, we examined self-weighing during and after pregnancy. Participants (N = 236) were 30.2 years old on average (SD = 4.7), with the majority being college-educated (53.8%, n = 127), earning at least $30,000 annually (61.4%, n = 145), and self-identifying as non-Hispanic White (NHW; 68.2%, n = 161). Adherence to regular self-weighing (at least once weekly) was highest among participants during pregnancy, with a considerable decline after giving birth. Low-income Black participants (earning < $30,000) were significantly less likely to reach a completion rate of ≥ 80% during pregnancy (AOR = 0.10) or the postpartum period (AOR = 0.16), compared to NHW participants earning at least $30,000 annually. Increases in perceived stress were associated with decreased odds of sustained self-weighing after delivery (AOR = 0.79). Future research should consider behavioral differences across demographic intersections, such as race and socioeconomic status, and the impact on efficacy of self-weighing.

OR21-07-23 Gestational Weight Gain and Its Effect on Short-and Long-Term Postpartum Weight Retention: An Updated Systematic Review and Meta-Analysis

OR21-07-23 Gestational Weight Gain and Its Effect on Short-and Long-Term Postpartum Weight Retention: An Updated Systematic Review and Meta-Analysis

Effects of Sexed and Conventional Semen Use and Calf Sex on Milk Yield Parameters, Body Weight and Milk Electrical Conductivity in Holstein Cows

This study was designed to determine the effects of semen type and calf gender on milk yield parameters, milk electrical conductivity and milk flow values and postpartum maternal body weight. A total of 265 Holstein cows in the first lactation were used in the study. The effect of sperm type on maternal body weight levels after calving and milk electrical conductivity values was significant (P0.05). Heifers inseminated with sexed semen had higher 100-days milk yield, milk peak yield and postpartum maternal body weight in the first lactation. Milk peak duration was higher in heifers inseminated with conventional semen (P0.05). In conclusion, heifers inseminated with sexed semen had higher maternal body weights, 100-days milk yield, milk peak yields and milk electrical conductivity levels in the first lactation than inseminated with conventional semen

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

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 &amp;lt;0% (n=100), weight gain 0-6% (n=110), and weight gain &amp;gt;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 &amp;lt;0% group to weight gain 0-6% to weight gain &amp;gt;6% (all p&amp;lt;0.05). On logistic regression analyses of prediabetes/diabetes at 5-years postpartum, weight gain &amp;gt;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 &amp; Co., Inc. R. Retnakaran: Research Support; Boehringer Ingelheim/Mount Sinai Hospital, Novo Nordisk. Other Relationship; Sanofi, Eli Lilly and Company.

A Cross-Sectional Survey of 505 Postpartum Women to Assess Lifestyle-Related Behaviour, Barriers, and Myths Affecting Postpartum Weight Retention and Its Management.

This study aims to assess lifestyle-related factors such as diet, physical activity and sleep along with common myths, beliefs, and barriers to a healthy lifestyle and resultant postpartum weight retention. It has also explored the association of the aforementioned factors with socio-demographic variables. A cross-sectional survey was conducted using a comprehensive pre-validated questionnaire on a convenience sample of postpartum women using a telephonic interview schedule. A total of 505 postpartum women were recruited with median postpartum weight retention of 5kg. More than half of the participants had incorrect dietary practices with less than one-tenth of women indulging in low/moderate-intensity physical activity. Postpartum women had poorer diet (p < 0.05) and sleep (p < 0.01) in the initial phase postpartum as compared to late postpartum. These women were also less physically active in the initial months and as the postpartum period progressed their physical activity also improved significantly (p < 0.001). Socio-demographic variables such as socio-economic status, education, and employment status were significantly associated with unhealthy lifestyle practices. Common barriers were lack of knowledge, time constraints, lack of childcare support and cultural myths and beliefs. The findings of the study will help in developing a comprehensive women-centric weight management module focusing on practical guidelines for lifestyle, breastfeeding and other confounding factors associated with postpartum weight management.

0204 Associations of Reallocating Sedentary or Activity Time to Sleep on Body Weight in Postpartum Women

Abstract Introduction In the postpartum period, decreased sleep time is associated with increased postpartum weight retention. Increasing sleep time in the postpartum period may be beneficial; however, increasing total sleep time will reduce the time available for light physical activity (LPA), moderate to vigorous activity (MVPA), or sedentary behavior (SED). Therefore, the purpose of this study was to examine the associations of reallocating time in SED, MVPA, and LPA to sleep with body weight in postpartum women. Methods Women (n=130) who gave birth to a singleton infant at ≥37 weeks gestation participated in the study. At 6-8 weeks, 6 months, and 12 months postpartum wrist actigraphy was used to measure total sleep time and hip actigraphy was used to measure SED, LPA, and MVPA. Women were instructed to wear the monitors for 7 days and maintain their normal daily activities. Weight was measured at each timepoint using a calibrated scale. Isotemporal substitution models were preformed to examine the association of reallocating time to sleep from SED, LPA, and MVPA on body weight. Results At 6-8 weeks, reallocating ten minutes of SED or MVPA to sleep was associated with a -0.54 kg (p=0.0223) and -3.33 kg (p=0.0091) change in body weight, respectively. At 6 months, reallocating ten minutes of SED or MVPA to sleep was associated with a -0.931 kg (p=0.0069) and -2.97 kg (p=0.0434) change in body weight, respectively. At 12 months, reallocating ten minutes of SED to sleep was associated with a -1.21 kg (p=0.0166) change in body weight. Reallocating time from MVPA to sleep was not associated with changes in body weight at 12 months. Reallocating time from LPA to sleep was not associated with changes in body weight at any timepoint. Conclusion Throughout the first year postpartum, reallocating time from SED to sleep was associated with decreases in body weight. Surprisingly, reallocating time from MVPA to sleep was also associated with a decrease in body weight at 6-8 weeks and 6 months postpartum. These results suggest the relative importance of the behaviors comprising the 24-hour day to body weight may be changing over the first year postpartum. Support (if any) NIH Grant R21MD012740

0728 Does Short Sleep Duration Increase Risk for Postpartum Weight Retention?

Abstract Introduction About 75% of mothers in the United States have postpartum weight retention (PWR), which increases risk for adverse health outcomes in mother and child. Short sleep duration is an important health behavior linked to risk of weight gain in the general population. Although short sleep duration is common in postpartum, findings from the few studies examining sleep duration and PWR are mixed. Thus, we aimed to examine whether sleep duration at 6 months postpartum is associated with PWR at 12 months. We also explored agreement between self-reported and actigraphy-derived sleep duration. Methods This is a secondary analysis from a prospective cohort study investigating postpartum pelvic floor outcomes. Participants were healthy, age ≥18 years, and primiparous with a singleton birth. We measured sleep duration by triaxial, wrist accelerometer (Actigraph GT3X+) and by self-report using the Pittsburgh Sleep Quality Index (PSQI). Excessive PWR was defined as ≥7% of pre-pregnancy weight. Log-binomial regression assessed the relationship between sleep duration and PWR, adjusted for pre-pregnancy body mass index, gestational weight gain, and breastfeeding. We analyzed agreement between self-reported and actigraphy-derived sleep duration using Bland-Altman analysis and paired t-test. Results Participants (N=467; mean age=29.5±4.78 years; pre-pregnancy BMI= 24.4±5.03 kg/m2) were mostly White (91%) and educated (93%). After adjustment, sleep duration by actigraphy (Risk Ratio (RR)=0.96, 95% confidence interval (CI)=(0.87,1.06), p=0.44,) and by PSQI (RR=0.95, 95%CI=(0.84,1.07), p=0.38) was not associated with PWR. There was a statistically significant correlation between sleep duration by actigraphy and by PSQI (r=0.19, 95% CI=(0.10,0.28), p&amp;lt; 0.001). The limits of agreement were wide (-3.41 to 3.57 hours), and self-reported versus actigraphy-derived sleep duration was not statistically different (bias=0.08 hours, p=0.3313) indicating no pattern of underestimating or overestimating. Conclusion In contrast to some previous findings, sleep duration at 6 months postpartum was not associated with PWR at 12 months. The assessment of additional sleep dimensions, such as timing or efficiency, may further refine our understanding of how sleep affects PWR. Self-reported and actigraphy-derived measures of sleep duration evidenced wide discrepancies in postpartum women, suggesting that the method of sleep measurement may contribute to mixed findings related to sleep in this population. Support (if any)

Maternal preconception BMI and gestational weight gain are associated with weight retention and maternal and child body fat at 6-7 years postpartum in the PRECONCEPT cohort.

There is limited evidence from prospective cohorts in low-resource settings on the long-term impact of pre-pregnancy body mass index (PPBMI) and gestational weight gain (GWG) on postpartum weight retention (PPWR) and maternal and child body composition. We examined the associations between PPBMI and timing of GWG on PPWR at 1, 2, and 6-7 years and maternal and child percent body fat at 6-7 years. We used data from the PRECONCEPT study (NCT01665378) that included prospectively collected data on 864 mother-child pairs from preconception through 6-7 years postpartum. The key outcomes were PPWR at 1, 2, and 6-7 years, and maternal and child percent body fat at 6-7 years that was measured using bioelectric impedance. Maternal conditional GWG (CGWG) was defined as window-specific weight gains (< 20wk, 21-29wk, and ≥ 30wk), uncorrelated with PPBMI and all prior body weights. PPBMI and CGWG were calculated as standardized z-scores to allow for relative comparisons of a 1 standard deviation (SD) increase in weight gain for each window. We used multivariable linear regressions to examine the associations, adjusting for baseline demographic characteristics, intervention, breastfeeding practices, diet and physical activity. Mean (SD) PPBMI and GWG were 19.7 (2.1) kg/m2 and 10.2 (4.0) kg, respectively. Average PPWR at 1, 2, and 6-7 years was 1.1, 1.5 and 4.3 kg, respectively. A one SD increase in PPBMI was associated with a decrease in PPWR at 1 year (β [95% CI]: -0.21 [-0.37, -0.04]) and 2 years (-0.20 [-0.39, -0.01]); while a one SD in total CGWG was associated with an increase in PPWR at 1 year (1.01 [0.85,1.18]), 2 years (0.95 [0.76, 1.15]) and 6-7 years (1.05 [0.76, 1.34]). Early CGWG (< 20 weeks) had the greatest association with PPWR at each time point as well as with maternal (0.67 [0.07, 0.87]) and child (0.42 [0.15, 0.69]) percent body fat at 6-7 years. Maternal nutrition before and during pregnancy may have long-term implications for PPWR and body composition. Interventions should consider targeting women preconception and early in pregnancy to optimize maternal and child health outcomes.

A WIC-Based Behavior Change Intervention for Postpartum Women With Overweight and Obesity: A Pilot Feasibility Randomized Trial.

Background. Postpartum weight retention is a risk factor for obesity and is particularly important among Hispanic women who have an increased rate of obesity. Given its broad reach, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program provides an ideal setting to implement community-based interventions for low-income postpartum women. Purpose. To examine the feasibility, acceptability, and preliminary efficacy of a multicomponent intervention delivered by staff within the WIC program designed to promote behavior changes in urban, postpartum women with overweight/obesity. Method. This was a 12-week pilot trial randomizing participants to a health behavior change (Intervention) or control (Observation) group. The Intervention included monthly visits with trained WIC staff providing patient-centered behavior change counseling, with multiple touchpoints between visits promoting self-monitoring and offering health behavior change support. Results. Participants (n = 41), who were mainly Hispanic (n = 37, 90%) and Spanish-speaking (n = 33, 81%), were randomized to the Intervention (n = 19) or Observation (n = 22) group. In the Intervention group, 79% (n = 15) of eligible participants were retained for the study duration. All Intervention participants endorsed that they would participate again. Regarding physical activity, participant readiness to change and self-efficacy improved for Intervention participants. About one-quarter of women in the Intervention group (27%, n = 4) had a 5% weight loss compared with one woman (5%) in the Observation group; this difference was not statistically significant (p = .10). Conclusions. This pilot demonstrated the feasibility and acceptability of delivering a low-intensity behavior change intervention within the WIC setting for postpartum women with overweight/obesity. Findings support the role of WIC in addressing postpartum obesity.

Per- and Polyfluoroalkyl Substances (PFAS) Mixture during Pregnancy and Postpartum Weight Retention in the New Hampshire Birth Cohort Study (NHBCS).

Per- and polyfluoroalkyl substances (PFAS), widely used in industrial and consumer products, are suspected metabolic disruptors. We examined the association between a PFAS mixture during pregnancy and postpartum weight retention in 482 participants from the New Hampshire Birth Cohort Study. PFAS concentrations, including perfluorohexane sulfonate, perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), perfluorononanoate (PFNA), and perfluorodecanoate, were quantified in maternal plasma collected at ~28 gestational weeks. Postpartum weight change was calculated as the difference between self-reported weight from a postpartum survey administered in 2020 and pre-pregnancy weight abstracted from medical records. Associations between PFAS and postpartum weight change were examined using Bayesian kernel machine regression and multivariable linear regression, adjusting for demographic, reproductive, dietary, and physical activity factors; gestational week of blood sample collection; and enrollment year. PFOS, PFOA, and PFNA were positively associated with postpartum weight retention, and associations were stronger among participants with a higher pre-pregnancy body mass index. A doubling of PFOS, PFOA, and PFNA concentrations was associated with a 1.76 kg (95%CI: 0.31, 3.22), 1.39 kg (-0.27, 3.04), and 1.04 kg (-0.19, 2.28) greater postpartum weight retention, respectively, among participants who had obesity/overweight prior to pregnancy. Prenatal PFAS exposure may be associated with increased postpartum weight retention.

Weight retention and glucose intolerance in early postpartum after gestational diabetes.

To determine risk factors for early postpartum weight retention (PPWR) and glucose intolerance (GI) in women with gestational diabetes (GDM). Prospective, multicenter (n=8) cohort study in 1201 women with a recent history of GDM. Pregnancy and postpartum characteristics, and data from self-administered questionnaires were collected at the 6-16 weeks postpartum 75g OGTT. Of all participants, 38.6% (463) had moderate (>0 and ≤5 kg) and 15.6% (187) had high (>5kg) PPWR. Independent predictors for early PPWR were excessive gestational weight gain (GWG), lack of breastfeeding, higher dietary fat intake, insulin use during pregnancy, multiparity, lower prepregnancy BMI, and lower education degree. Compared to PPWR <5 kg, women with high PPWR had a more impaired postpartum metabolic profile, breastfed less often, had higher depression rates [23.1% (43) vs. 16.0% (74), p=0.035] and anxiety levels, and lower quality of life. Of all participants, 28.0% (336) had GI [26.1% (313) prediabetes and 1.9% (23) diabetes]. Women with high PPWR had more often GI compared to women without PPWR [33.7% (63) vs. 24.9% (137), p=0.020]. Only 12.9% (24) of women with high PPWR perceived themselves at high risk for diabetes but they were more often willing to change their lifestyle than women with moderate PPWR. Modifiable risk factors such as lifestyle, prepregnancy BMI, GWG, and mental health can be used to identify a subgroup of women with GDM at the highest risk of developing early PPWR, allowing for a more personalized follow-up.

Relationships among Postpartum Weight Retention, Stress, and Disinhibited Eating: A Scoping Review.

Postpartum weight retention (PPWR) is a significant contributor to maternal cardiometabolic disease risk. The transition to motherhood is a stressful time period in which women report consuming food to cope, an eating behavior that is associated with PPWR. In this scoping review, we identified original research and review articles published since 2010 that examined relationships among PPWR, maternal stress, and disinhibited eating. In total, 16 articles met the inclusion criteria. Findings were inconsistent related to PPWR and stress. PPWR and disinhibited eating were not significantly correlated; however, disinhibition scores were higher during the postpartum period compared to prenatally. Stress and disinhibited eating were directly correlated in 4 studies. Our findings suggest these concepts, particularly disinhibited eating, have not been robustly examined during the postpartum period. Additionally, instruments used to measure maternal stress vary widely and should be further studied and refined.

11 Impact of a Cache Valley Fever Outbreak on Lambing Performance in a Landrace Hair Sheep Flock: A Case Study

Abstract Cache Valley Fever (CVF) is a mosquito-born, viral disease endemic to North America. While generally not associated with clinical symptoms in ewes, it affects fetal development during the first trimester of pregnancy resulting in malformations and pregnancy loss. A suspected outbreak of CVF was recorded in a flock of Barbados Blackbelly and St. Croix hair sheep managed under an 8-mo, accelerated mating system with ewes bred in March, July and November. The outbreak was associated with a July breeding, in a summer with unusually high rainfall and standing water in pastures. There had been no previous occurrence of CVF or other abortion storms in the flock (20+ years). Lambing outcome associated with the suspected outbreak of CVF was compared with that of the three prior July matings (CON). Ewes (n = 32-35) were managed in a pasture-based system under rotational grazing. Ewes were mated in two single sire groups of 16 to 18 ewes to like-breed sires each breeding season. Pregnancy was determined by transrectal ultrasound at end and 21 d after the 25-day breeding season. Ewes lambed on pasture, and lambs were tagged, and birth weights recorded within 24 hours. Blood samples were collected from all ewes following the CVF lambing and submitted for CVF antibody testing. All ewes showed CVF antibody titers. Pregnancy rate for the CVF lambing was not different from CON (85.7 vs. 89.8%; P = 0.512), whereas lambing rate was less in CVF for both ewes exposed (74.3 vs. 88.8%; P = 0.039) and ewes lambing (86.7 vs. 98.9%; P = 0.004). Incidence of stillborn and neonatal death of lambs was greater in CVF than CON (37.0 vs.5.6%; P = 0.002), as was the number of malformed lambs (13.0 vs. 0%; P &amp;lt; 0.001). Malformed lambs were associated with breech presentations. Litter size was not different in the CVF lambing (1.77 vs 1.86; P = 0.471), but lamb birth weight tended to be less (2.80 vs. 3.04 kg; P = 0.055) while ewe postpartum weight was not different (45.3 vs. 47.0 kg; P = 0.384). The outbreak of CVF reduced the lambing rate and increased the incidence of neonatal death and malformations. The outbreak occurred during a summer with unusually high rainfall and may be associated with changing weather patterns linked to climate change. Delaying summer breeding may be considered a mitigation strategy if feasible.