Associations between postpartum weight retention, gestational weight gain and birth outcomes in successive pregnancies

Objective: Little is known about the effects of postpartum weight retention on gestational weight gain and birth outcomes in successive pregnancies. The purpose of this study is to determine the association between postpartum weight retention and subsequent adherence to IOM gestational weight gain guidelines. Associations will be examined by body-mass index (BMI) status and the impact on birth outcomes will be explored.

Methods: Florida vital records were analyzed for the period of 2005 to 2010. Chi-square tests and multivariable Poisson regressions were conducted to determine the associations. Models were adjusted for inter-pregnancy interval, tobacco use, maternal age, and race/ethnicity.

Results: Obese women who gained inadequate weight were more likely to have retained weight postpartum prior to pregnancy compared to obese women who met or exceeded the recommended weight gain. Risks for preterm birth increased in all women who did not gain adequate weight. Gaining excessive weight was protective for SGA in all BMI categories but increased the risks for LGA. Underweight weight women who gained in excess of IOM recommendations were at increased risk for developing hypertension compared to normal weight women who had optimal weight gain.

Conclusion: Women who retain or gain weight postpartum are at a higher risk for not gaining adequate weight in a successive pregnancy. Understanding the dynamic between inter-pregnancy weight retention and gestational weight gain is critical to helping women achieve optimal outcomes.