TY - JOUR

T1 - How do pregnancy-related weight changes and breastfeeding relate to maternal weight and BMI-adjusted waist circumference 7 y after delivery?

T2 - Results from a path analysis

AU - Kirkegaard, Helene

AU - Stovring, Henrik

AU - Rasmussen, Kathleen M

AU - Abrams, Barbara

AU - Sørensen, Thorkild I A

AU - Nohr, Ellen A

PY - 2014/2

Y1 - 2014/2

N2 - BACKGROUND: Reproduction has been related to long-term maternal weight gain, and changes in fat mass, with gestational weight gain, have been identified as an important contributor. However, the influence of weight changes during the whole reproductive cycle and the modifying effect of breastfeeding are unknown.OBJECTIVE: The objective was to examine how prepregnancy weight, gestational weight gain, postpartum weight changes, and breastfeeding influence maternal weight and body mass index-adjusted waist circumference (WCBMI) 7 y after delivery.DESIGN: This was a prospective cohort study of 23,701 women participating in the Danish National Birth Cohort with singleton births and no births during follow-up. Path analysis was used to assess the total, direct, and indirect effects; the latter was mediated through weight changes on the pathways.RESULTS: Postpartum weight retention at 6 mo and weight gain from 6 to 18 mo postpartum were highly positively associated with both outcomes. A 1-kg increase in weight retention at 6 mo postpartum corresponded to an average increase of 0.5 kg at 7 y. Gestational weight gain was not associated with WCBMI but was positively associated with weight at 7 y; 87% of this effect was mediated through later weight changes. For both outcomes, a small inverse association was observed for breastfeeding duration. This was strongest for WCBMI, for which 97% of the effect was direct, ie, not mediated through postpartum weight.CONCLUSIONS: These findings show that postpartum weight retention at 6 mo and weight gain from 6 to 18 mo postpartum contribute equally to adverse maternal anthropometric measures 7 y after delivery. Breastfeeding duration may have a beneficial effect.

AB - BACKGROUND: Reproduction has been related to long-term maternal weight gain, and changes in fat mass, with gestational weight gain, have been identified as an important contributor. However, the influence of weight changes during the whole reproductive cycle and the modifying effect of breastfeeding are unknown.OBJECTIVE: The objective was to examine how prepregnancy weight, gestational weight gain, postpartum weight changes, and breastfeeding influence maternal weight and body mass index-adjusted waist circumference (WCBMI) 7 y after delivery.DESIGN: This was a prospective cohort study of 23,701 women participating in the Danish National Birth Cohort with singleton births and no births during follow-up. Path analysis was used to assess the total, direct, and indirect effects; the latter was mediated through weight changes on the pathways.RESULTS: Postpartum weight retention at 6 mo and weight gain from 6 to 18 mo postpartum were highly positively associated with both outcomes. A 1-kg increase in weight retention at 6 mo postpartum corresponded to an average increase of 0.5 kg at 7 y. Gestational weight gain was not associated with WCBMI but was positively associated with weight at 7 y; 87% of this effect was mediated through later weight changes. For both outcomes, a small inverse association was observed for breastfeeding duration. This was strongest for WCBMI, for which 97% of the effect was direct, ie, not mediated through postpartum weight.CONCLUSIONS: These findings show that postpartum weight retention at 6 mo and weight gain from 6 to 18 mo postpartum contribute equally to adverse maternal anthropometric measures 7 y after delivery. Breastfeeding duration may have a beneficial effect.

KW - Adult

KW - Body Mass Index

KW - Breast Feeding

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Linear Models

KW - Postpartum Period

KW - Pregnancy

KW - Prospective Studies

KW - Questionnaires

KW - Socioeconomic Factors

KW - Waist Circumference

KW - Weight Gain

U2 - 10.3945/ajcn.113.067405

DO - 10.3945/ajcn.113.067405

M3 - Journal article

C2 - 24335054

VL - 99

SP - 312

EP - 319

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

SN - 0002-9165

IS - 2

ER -