Title: Excessive gestational weight gain is associated with long-term body fat and weight retention at 7 y postpartum in African American and Dominican mothers with underweight, normal, and overweight prepregnancy BMI.

Authors: Widen, Elizabeth M; Whyatt, Robin M; Hoepner, Lori A; Ramirez-Carvey, Judyth; Oberfield, Sharon E; Hassoun, Abeer; Perera, Frederica P; Gallagher, Dympna; Rundle, Andrew G

Published In Am J Clin Nutr, (2015 Dec)

Abstract: Excessive gestational weight gain (GWG) is associated with postpartum weight retention (PPWR) and abdominal adiposity, but long-term effects are understudied in low-income and minority populations at high risk of obesity and associated sequelae.We examined associations between GWG and long-term PPWR and adiposity in a prospective cohort of African American and Dominican mothers in the Bronx and Northern Manhattan.Women (n = 302) were enrolled during pregnancy and were followed for 7 y postpartum. Linear regression was used to relate excessive GWG [greater than 2009 Institute of Medicine (IOM) guidelines] to outcomes [percentage body fat and long-term PPWR (change in weight from prepregnancy to 7 y postpartum)], adjusting for covariates and included an interaction term between prepregnancy body mass index (BMI; in kg/m(2)) and GWG.Mean ± SD prepregnancy BMI and total GWG were 25.6 ± 5.8 (42% of women had BMI ≥25) and 16.6 ± 7.8 kg (64% of women had total GWG greater than IOM guidelines), respectively. Associations between GWG and long-term PPWR and the percentage body fat varied by prepregnancy BMI (P-interaction ≤ 0.06); excessive GWG was associated with a higher percentage body fat and greater long-term PPWR in mothers with lower prepregnancy BMI. To illustrate the interaction, a predicted covariate-adjusted model, which was used to derive estimates for the percentage body fat and PPWR associated with excessive GWG, was estimated for 2 prepregnancy BMI examples. For a woman with prepregnancy BMI of 22, excessive GWG was associated with 3.0% higher body fat (P < 0.001) and a 5.6-kg higher PPWR (P < 0.001); however, for a woman with a prepregnancy BMI of 30, excessive GWG was associated with 0.58% higher body fat (P = 0.55) and 2.06 kg PPWR (P = 0.24).Long-term adiposity and PPWR in low-income African American and Dominican mothers were predicted by interacting effects of prepregnancy BMI and excessive GWG. The provision of support for mothers to begin pregnancy at a healthy weight and to gain weight appropriately during pregnancy may have important lasting implications for weight-related health in this population. This study was registered at clinicaltrials.gov as NCT00043498.

PubMed ID: 26490495

MeSH Terms: Adiposity*/ethnology; Adolescent; Adult; Black or African American; Body Mass Index; Cohort Studies; Dominican Republic/ethnology; Female; Follow-Up Studies; Hispanic or Latino; Humans; Lost to Follow-Up; New York City/epidemiology; Overweight/epidemiology*; Overweight/ethnology; Postpartum Period; Poverty; Pregnancy; Pregnancy Complications/epidemiology*; Pregnancy Complications/ethnology; Prenatal Nutritional Physiological Phenomena*/ethnology; Prospective Studies; Recurrence; Risk; Thinness/epidemiology*; Thinness/ethnology; Weight Gain/ethnology; Young Adult