Pre-pregnancy BMI, gestational weight gain and postpartum weight retention: a meta-analysis of observational studies

• Published in: Public health nutrition 2015-08, Vol.18 (12), p.2172-2182
• Main Authors: Rong, Ke, Yu, Kai, Han, Xiaolong, Szeto, Ignatius MY, Qin, Xueying, Wang, Junkuan, Ning, Yibing, Wang, Peiyu, Ma, Defu
• Format: Article
• Language: English
• Subjects: Body Mass Index; Databases, Factual; Diet; Epidemiology; Female; Humans; Meta-analysis; Motor Activity; Nutritional epidemiology; Obesity; Observational studies; Observational Studies as Topic; Overweight; Postpartum Period; Pregnancy; Qualitative research; Research methodology; Retention; Review Article; United States; Weight control; Weight Gain; Womens health
• ISSN: 1368-9800; 1475-2727
• DOI: 10.1017/S1368980014002523

To determine the association of gestational weight gain (GWG) or pre-pregnancy BMI with postpartum weight retention (PPWR). Meta-analysis. PubMed, Cochrane Controlled Trials Register, EMBASE, Science Citation Index Expanded, Current Contents Connects and Biosis Previews were used to search articles. Publications that described the influence of pre-pregnancy BMI or GWG on PPWR. Seventeen studies that satisfied the eligibility criteria were included in the analyses. Women with inadequate and excessive GWG had significantly lower mean PPWR of -2·14 kg (95 % CI -2·43, -1·85 kg) and higher PPWR of 3·21 kg (95 % CI 2·79, 3·62 kg), respectively, than women with adequate GWG. When postpartum time spans were stratified into 1-3 months, 3-6 months, 6-12 months, 12-36 months and ≥15 years, the association between inadequate GWG and PPWR faded over time and became insignificant (-1·42 kg; 95 % CI -3·08, 0·24 kg) after ≥15 years. However, PPWR in women with excess GWG exhibited a U-shaped trend; that is, a decline during the early postpartum time span (year 1) and then an increase in the following period. Meta-analysis of qualitative studies showed a significant relationship between excessive GWG and higher PPWR risk (OR=2·08; 95 % CI 1·60, 2·70). Moreover, meta-analysis of pre-pregnancy BMI on PPWR indicated that mean PPWR decreased with increasing BMI group. These findings suggest that GWG, rather than pre-pregnancy BMI, determines the shorter- or longer-term PPWR.