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Nutrients. 2020 Jan 7;12(1). pii: E170. doi: 10.3390/nu12010170.

Patterns of Weight Change One Year after Delivery Are Associated with Cardiometabolic Risk Factors at Six Years Postpartum in Mexican Women.

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Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad no. 655, Santa María Ahuacatitlán, Cuernavaca, Morelos 62100, Mexico.
National Council on Science and Technology, Avenida Insurgentes Sur no. 1582, San José Insurgentes, Benito Juárez, Ciudad de México 08400, Mexico.
Division of Community Interventions Research, National Institute of Perinatology, Montes Urales no. 800, Lomas de Virreyes, Miguel Hidalgo, Ciudad de México 11000, Mexico.
Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, 722 West 168th Street, Suite 1105E, New York, NY 10032, USA.
Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 East 102 Street Floor 3, New York, NY 10029, USA.
College of Global Public Health, New York University, 715 Broadway, New York, NY 10003, USA.
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Landmark Center, 401 Park Drive, Suite 401 East Boston, MA 02215, USA.
National Center for Prevention Programs and Disease Control, Benjamín Franklin no.132, Escandón, Miguel Hidalgo, Ciudad de México 11800, Mexico.


Pregnancy is a contributor to the obesity epidemic in women, probably through postpartum weight retention (PPWR), weight gain (PPWG), or a combination of both (PPWR + WG). The contribution of these patterns of postpartum weight change to long-term maternal health remains understudied. In a secondary analysis of 361 women from the prospective cohort PROGRESS, we evaluated the associations between patterns of weight change one year after delivery and cardiometabolic risk factors at six years postpartum. Using principal component analysis, we grouped cardiometabolic risk factors into: (1) body mass index (BMI), waist circumference (WC), homeostatic model assessment of insulin resistance (HOMA-IR), high-density lipoprotein cholesterol (HDL-c), triglycerides (TG), and glucose; (2) systolic (SBP) and diastolic blood pressure (DBP); and (3) low-density lipoprotein cholesterol and total cholesterol. Using path analysis, we studied direct (patterns of weight change-outcomes) and indirect associations through BMI at six years postpartum. Around 60% of women returned to their pregestational weight (reference) by one year postpartum, 6.6% experienced PPWR, 13.9% PPWG, and 19.9% PPWR + WG. Women with PPWR + WG, vs. the reference, had higher BMI and WC at six years (2.30 kg/m2, 95% CI [1.67, 2.93]; 3.38 cm [1.14, 5.62]). This was also observed in women with PPWR (1.80 kg/m2 [0.80, 2.79]; 3.15 cm [-0.35, 6.65]) and PPWG (1.22 kg/m2 [0.53, 1.92]; 3.32 cm [0.85, 5.78]). PPWR + WG had a direct association with HOMA-IR (0.21 units [0.04, 0.39]). The three patterns of weight change, vs. the reference, had significant indirect associations with HOMA-IR, glucose, TG, HDL-c, SBP, and DBP through BMI at six years. In conclusion, women with PPWR + WG are at high-risk for obesity and insulin resistance. Interventions targeting women during pregnancy and the first year postpartum may have implications for their long-term risk of obesity and cardiovascular disease.


PROGRESS cohort; Postpartum weight change; adiposity; cardiovascular risk; postpartum weight gain; postpartum weight retention

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