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Weight development over time in parous women—The SPAWN study—15 years follow-up

Abstract

BACKGROUND: Weight gain is common after pregnancy. Most studies suggest that weight gain associated with a pregnancy is between 0.5 and 3.8 kg up to 2.5 y of follow-up. However, 73% of the female patients at our obesity clinic identified pregnancy as an important trigger for marked weight retention. The majority retained more than 10 kg after each pregnancy. The aim of this study was to examine long-term weight development after pregnancy in a 15 y follow-up of women who took part in the Stockholm Pregnancy And Women's Nutrition (SPAWN) study.

METHOD AND SUBJECTS: The SPAWN study is a long-term follow-up study of women who delivered children in 1984–85 in Stockholm (n=2342). A total of 1423 participants (response rate=61%) completed questionnaires, which covered eating behaviour and exercise, demographic information including social situation and status and details of the pregnancy before, during and up to 1 y after pregnancy. After 15 y, these women were invited to take part in the follow-up study. Anthropometric measurements and the same questionnaire data were collected from the 563 women who participated (response rate=40%). The sample was divided into two main groups: those who were normal weight before pregnancy and remained normal weight, and those who were normal weight before pregnancy and had become overweight at 15 y follow-up.

RESULTS: Those women who became overweight had a higher pre-pregnant body mass index (BMI) (22.3±1.5 vs 20.5±1.6 kg/m2, P<0.001), gained more weight during pregnancy (16.3±4.3 vs 13.6±3.7 kg, P<0.001) and had retained more at 1 y follow-up. The women who became overweight had a steeper weight trajectory gaining more from 1 y follow-up to 15 y follow-up (11.1±6.5 vs 4.5±6.5 kg, P<0.001), with a higher BMI at 15 y follow-up of 27.5±2.6 vs 22.5±2.3 5 kg/m2 (P<0.001). However, differences between those who became overweight and those who did not could not be explained by age, number of children and various socioeconomic factors. Features of pregnancy that did differ between the two groups were breastfeeding and smoking cessation. However, women who became overweight had lower lactation scores than women who remained normal weight. Relatively more subjects of the group that became overweight stopped smoking during pregnancy.

DISCUSSION: Pregnancy is a vulnerability factor for some women to become overweight. This study attempted to identify those factors that place initially normal weight women on a steeper weight trajectory as a result of pregnancy. Demographic, behavioural, physical and psychological characteristics only partly explain the weight gain observed at 15 y follow-up. Further research is required to investigate the relative role of these characteristics in predicting postpregnancy weight development.

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References

  1. Lissner L, Johansson SE, Qvist J, Rossner S, Wolk A . Social mapping of the obesity epidemic in Sweden. Int J Obes Relat Metab Disord 2000; 24: 801–805.

    Article  CAS  Google Scholar 

  2. Arner P . Hunting for human obesity genes? Look in the adipose tissue!. Int J Obes Relat Metab Disord 2000; 24 (Suppl 4): S57–S62.

    Article  CAS  Google Scholar 

  3. Grilo CM, Pogue-Geile MF . The nature of environmental influences on weight and obesity: a behavior genetic analysis. Psychol Bull 1991; 110: 520–537.

    Article  CAS  Google Scholar 

  4. DiPietro L . Physical activity, body weight, and adiposity: an epidemiological perspective. In: Holloszy JO (ed). Exercise and sport science reviews. Vol 23. Williams & Wilkins: Baltimore; 1995. pp 275–303.

    Google Scholar 

  5. Blundell JE, Tremblay A . Appetite control and energy (fuel) balance. Nutr Res Rev 1995; 8: 225–242.

    Article  CAS  Google Scholar 

  6. WHO. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation on Obesity, 3–5 June 1997 Geneva: WHO; 1998.

  7. Fernström MH . Drugs that cause weight gain. Obes Res 1995; 3: 435S–439S.

    Article  Google Scholar 

  8. Öhlin A, Rössner S . Maternal body weight development after pregnancy. Int J Obes Relat Metab Disord 1990; 14: 159–173.

    Google Scholar 

  9. Greene JA . Clinical study of the etiology of obesity. Ann Intern Med 1939; 12: 1797–1803.

    Article  Google Scholar 

  10. Sheldon JH . Maternal obesity. Lancet 1949; ii: 869–873.

    Article  Google Scholar 

  11. Harris HE, Ellison GTH . Do the changes in energy balance that occur during pregnancy predispose parous women to obesity? Nutr Res Rev 1997; 10: 57–81.

    Article  CAS  Google Scholar 

  12. Rössner S . Pregnancy, weight cycling and weight gain in obesity. Int J Obes Relat Metab Disord 1992; 16: 145–147.

    PubMed  Google Scholar 

  13. Newcombe RG . Development of obesity in parous women. J Epidemiol Commun Health 1982; 36: 306–309.

    Article  CAS  Google Scholar 

  14. Brown JE, Kaye SA, Folsom AR . Parity-related weight change in women. Int J Obes Relat Metab Disord 1992; 16: 627–631.

    CAS  PubMed  Google Scholar 

  15. Williamson DF, Madans J, Pamuk E, Flegal KM, Kendrick JS, Serdula MK . A prospective study of childbearing and 10-year weight gain in US white women 25 to 45 years of age. Int J Obes Relat Metab Disord 1994; 18: 561–599.

    CAS  PubMed  Google Scholar 

  16. Cederlöf R, Kaij L . The effect of childbearing on body weight: a twin control study. Acta Psychiatr Scand Suppl 1970; 219: 47–49.

    Article  Google Scholar 

  17. Prentice AM, Whitehead RG, Roberts SB, Paul AA . Long-term energy balance in child-bearing Gambian women. Am J Clin Nutr 1981; 34: 2790–2799.

    Article  CAS  Google Scholar 

  18. Öhlin A, Rössner S . Maternal body weight and relation to birth weight. Acta Obstet Gynecol Scand 1990; 69: 475–478.

    Article  Google Scholar 

  19. Lowe GR, Gibson JR . Changes in body weight associated with age and marital status. BMJ 1955; 2: 1006–1008.

    Article  CAS  Google Scholar 

  20. Hunt SC, Daines MM, Adams TD, Heath EM, Williams RR . Pregnancy weight retention in morbid obesity. Obes Res 1995; 3: 121–130.

    Article  CAS  Google Scholar 

  21. Smith DE, Lewis CE, Caveny JL, Perkins LL, Burke GL, Bild DE . Longitudinal changes in adiposity associated with pregnancy. The CARDIA Study. Coronary Artery Risk Development in Young Adults Study. JAMA 1994; 271: 1747–1751.

    Article  CAS  Google Scholar 

  22. Harris HE, Ellison GTH, Holliday M, Lucassen E . The impact of pregnancy on the long term weight gain of primiparous women in England. Int J Obes Relat Metab Disord 1997; 21: 747–755.

    Article  CAS  Google Scholar 

  23. Walker LO . Predictors of weight gain at 6 and 18 months after childbirth: a pilot study. J Obstet Gynecol Neonat Nurs 1996; 25: 39–48.

    Article  CAS  Google Scholar 

  24. Crowell DT . Weight change in the postpartum period. A review of the literature. J Nurse Midwifery 1995; 40: 418–423.

    Article  CAS  Google Scholar 

  25. Rössner S, Öhlin A . Pregnancy as a risk factor for obesity: lessons from the Stockholm pregnancy and weight development study. Obes Res 1995; 3: 267s–275s.

    Article  Google Scholar 

  26. Öhlin A, Rössner S . Trends in eating patterns, physical activity and socio-demographic factors in relation to post-partum body weight development. Br J Nutr 1994; 71: 457–470.

    Article  Google Scholar 

  27. Schauberger CW, Rooney BL, Brimer LM . Factors that influence weight loss in the puerperium. Obstet Gynecol 1992; 79: 424–429.

    Article  CAS  Google Scholar 

  28. Harris HE, Ellison GTH, Clement S . Do the psychosocial and behavioural changes that accompany motherhood influence the impact of pregnancy on long-term weight gain? J Psychosom Obstet Gynaecol 1999; 20: 65–79.

    Article  CAS  Google Scholar 

  29. Walker LO . Weight and weight-related distress after childbirth: relationships of stress, social support, and depressive symptoms. J Holistic Nurs 1997; 15: 389–405.

    Article  CAS  Google Scholar 

  30. Parker J, Abrams B . Differences in postpartum weight retention between black and white mothers. Obstet Gynecol 1993; 81: 768–774.

    CAS  PubMed  Google Scholar 

  31. Gunderson EP, Abrams B, Selvin S . Does the pattern of postpartum weight change differ according to pregravid body size? Int J Obes Relat Metab Disord 2001; 25: 853–862.

    Article  CAS  Google Scholar 

  32. Soltani H, Fraser RB . A longitudinal study of maternal anthropometric changes in normal weight, overweight and obese women during pregnancy and postpartum. Br J Nutr 2000; 84: 95–101.

    Article  CAS  Google Scholar 

  33. Cnattingius S, Bergstrom R, Lipworth L, Kramer MS . Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med 1998; 338: 147–152.

    Article  CAS  Google Scholar 

  34. Sebire NJ, Jolly M, Harris JP, Wadsworth J, Joffe M, Beard RW, Regan L, Robinson S . Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord 2001; 25: 1175–1182.

    Article  CAS  Google Scholar 

  35. Janney C, Zhang D, Sowers M . Lactation and weight retention. Am J Clin Nutr 1997; 66: 1116–1124.

    Article  CAS  Google Scholar 

  36. Dewey KG, Heinig MJ, Nommsen LA . Maternal weight-loss patterns during prolonged lactation. Am J Clin Nutr 1993; 58: 162–166.

    Article  CAS  Google Scholar 

  37. Harris HE, Ellison GTH, Richter LM, DeWet T, Levin J . Are overweight women at increased risk of obesity following pregnancy? Br J Nutr 1998; 79: 489–494.

    Article  CAS  Google Scholar 

  38. Rookus MA, Rokebrand P, Burema J, Deurenberg P . The effect of pregnancy on the body mass index 9 months postpartum in 49 women. Int J Obes Relat Metab Disord 1987; 11: 609–618.

    CAS  Google Scholar 

  39. Boardley DJ, Sargent RG, Coker AL, Hussey JR, Sharpe PA . The relationship between diet, activity, and other factors, and postpartum weight change by race. Obstet Gynecol 1995; 86: 834–838.

    Article  CAS  Google Scholar 

  40. Muscati SK, Gray-Donald K, Koski KG . Timing of weight gain during pregnancy: promoting fetal growth and minimising maternal weight retention. Int J Obes Relat Metab Disord 1996; 20: 526–532.

    CAS  PubMed  Google Scholar 

  41. Thorsdottir I, Birgisdottir BE . Different weight gain in women of normal weight before pregnancy: postpartum weight and birth weight. Obstet Gynecol 1998; 92: 377–383.

    CAS  PubMed  Google Scholar 

  42. Brewer MM, Bates MR, Vannoy LP . Postpartum changes in maternal weight and body fat depots in lactating versus nonlactating women. Am J Clin Nutr 1989; 49: 259–265.

    Article  CAS  Google Scholar 

  43. Dugdale AE, Eaton-Evans J . The effect of lactation and other factors on post-partum changes in body-weight and triceps skinfold thickness. Br J Nutr 1989; 61: 149–153.

    Article  CAS  Google Scholar 

  44. Linne Y, Barkeling B, Rössner S . Long-term weight development after pregnancy. Obes Rev 2002; 3: 75–83.

    Article  CAS  Google Scholar 

  45. Schnell R . Graphisch gestützte Datenanalyse. Oldenbourg Verlag: München; 1994.

    Book  Google Scholar 

  46. Gunderson EP, Abrams B, Selvin S . The relative importance of gestational gain and maternal characteristics associated with the risk of becoming overweight after pregnancy. Int J Obes Relat Metab Disord 2000; 24: 1660–1668.

    Article  CAS  Google Scholar 

  47. Rooney BL, Schauberger CW . Excess pregnancy weight gain and long-term obesity: one decade later. Obstet Gynecol 2002; 100: 245–252.

    PubMed  Google Scholar 

  48. Lederman SA, Alfasi G, Deckelbaum RJ . Pregnancy-associated obesity in black women in New York City. Matern Child Health J 2002; 6: 37–42.

    Article  Google Scholar 

  49. Schieve LA, Cogswell ME, Scanlon KS . Maternal weight gain and preterm delivery: differential effects by body mass index. Epidemiology 1999; 10: 141–147.

    Article  CAS  Google Scholar 

  50. Barker DJP, Godfrey KM, Osmond C, Bull A . The relation of fetal length, ponderal index and head circumference to blood pressure and the risk of hypertension later in life. Paediatr Perinat Epidemiol 1992; 6: 35–44.

    Article  CAS  Google Scholar 

  51. Wadsworth MEJ, Kuh DJL . Childhood influences on adult health: a review of recent work from the British 1946 national birth cohort study, the MRC National Survey of Health and Development. Paediatr Perinat Epidemiol 1997; 11: 2–20.

    Article  CAS  Google Scholar 

  52. Poehlman ET, Toth MJ, Gardner AW . Changes in energy balance and body composition at menopause: a controlled longitudinal study. Ann Intern Med 1995; 123: 673–675.

    Article  CAS  Google Scholar 

  53. Davidson S, Passmore R, Brock JF . Obesity in human nutrition and dietetics. Churchill Livingstone: Bath; 1979. pp 244–254.

    Google Scholar 

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Acknowledgements

We thank Viveca Larsson Petre, Birgitta Spetz, Lena Mannström Svensson and Karin Östling for their enthusiastic support and help in this study. Agneta Öhlin was responsible for the data collection up to 1990.

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Linné, Y., Dye, L., Barkeling, B. et al. Weight development over time in parous women—The SPAWN study—15 years follow-up. Int J Obes 27, 1516–1522 (2003). https://doi.org/10.1038/sj.ijo.0802441

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