Associations of gestational weight gain with the long-term postpartum weight gain, body mass index, waist circumference and abdominal obesity: A 27-year prospective cohort study

Abdullah A Mamun; Emily Oken; Harold D McIntyre; Jake M Najman; Gail M Williams; Alexandra Clavarino; Tolassa W Ushula

doi:10.1016/j.orcp.2024.03.003

Associations of gestational weight gain with the long-term postpartum weight gain, body mass index, waist circumference and abdominal obesity: A 27-year prospective cohort study

Obes Res Clin Pract. 2024 Apr 3:S1871-403X(24)00033-4. doi: 10.1016/j.orcp.2024.03.003. Online ahead of print.

Authors

Abdullah A Mamun¹, Emily Oken², Harold D McIntyre³, Jake M Najman⁴, Gail M Williams⁴, Alexandra Clavarino⁴, Tolassa W Ushula⁵

Affiliations

¹ UQ Poche Centre for Indigenous Health, The University of Queensland, USA. Electronic address: a.mamun@uq.edu.au.
² Department of Population Medicine, Harvard University, Boston, USA.
³ School of Medicine, The University of Queensland, Brisbane, Australia; Mater Health Services, Brisbane, Queensland, USA.
⁴ School of Public Health, The University of Queensland, Brisbane, Australia.
⁵ UQ Poche Centre for Indigenous Health, The University of Queensland, USA; School of Public Health, The University of Queensland, Brisbane, Australia.

PMID: 38575407
DOI: 10.1016/j.orcp.2024.03.003

Abstract

Background: This prospective cohort study aimed to investigate the associations between gestational weight gain (GWG) and long-term postpartum maternal weight gain, body mass index (BMI), waist circumference (WC), and the risk of general and abdominal obesity, beyond motherhood (some 27 y after childbirth).

Methods: Participants were 1953 women enrolled in the Mater-University of Queensland Study of Pregnancy cohort study that started in the early 1980 s, with the most recent follow-up at 27 y postpartum. We examined the prospective associations of GWG in pregnancy with weight, BMI, and WC and the risk of adiposity 27 y after the index pregnancy. We used linear and multinomial logistic regressions to examine the independent effect of GWG on each outcome, adjusting for potential confounders and mediators.

Results: The average GWG during pregnancy was 14.88 kg (SD 5.24). One in four women (25.50%) gained below the Institute of Medicine (IOM) recommendations and one in three (34.00%) gained excess weight during pregnancy. Every 100 g/week increment of GWG was associated with 2.0 (95% CI: 1.5, 2.6) kg, 0.7 (0.5, 0.9) kg/m², 1.3 (0.8, 1.8) cm greater body weight, BMI, and WC, respectively 27 y postpartum. Women who gained inadequate weight in pregnancy had significantly lower odds of general obesity (OR; 0.70, 95% CI:0.53,0.94) or abdominal obesity (0.73; 0.56,0.96), whereas those who gained excess gestational weight had much higher odds of general obesity (4.49; 3.36,6.00) and abdominal obesity (3.09; 2.29,4.16). These associations were independent of potential confounders.

Conclusion: Maternal GWG in pregnancy independently and strongly predicted beyond motherhood weight gain trajectory. GWG within IOM recommendation may prevent long-term development of both general and central obesity.

Keywords: Gestational weight gain; Obesity; Post-partum weight; Waist circumference.