Overweight and Obesity following childbirth: Promoting healthy maternal weight is a missed opportunity for primary care. (#113)
Background: Postpartum weight retention (PPWR) increases the risk for adverse health outcomes during subsequent pregnancies and is associated with future maternal obesity. Understanding opportunities to limit PPWR is key in promoting healthy weight for women across the life-course.
Aims: To document change in maternal BMI across the perinatal period, assess frequency of health care provider’s advice regarding weight, diet, and physical activity and assess associations of frequency of advice with BMI and PPWR in a cohort of Melbourne women.
Methods: First time mothers (n=448) enrolled in the InFANT Extend study completed a baseline questionnaire at ̴ 3 months postpartum assessing provision of clinician advice during and following pregnancy. Pre-pregnancy weight and gestational weight-gain (GWG) were self-reported and postpartum height and weight were objectively measured. Chi Square tests assessed differences in provision of advice by BMI. Analysis of covariance adjusting for GWG assessed associations of advice with PPWR.
Results: Mean BMI increased from 24.8±4.9 kg/m² pre-pregnancy to 26.2±4.9 kg/m² at 3 months postpartum. The proportion of women classified obese (BMI≥30kg/m2) almost doubled from pre-pregnancy (11.8%) to 3 months postpartum (21.7%)(p<0.001). Mean PPWR at 3 months was 4.3±5.7kg and 21.2% of women had PPWR ≥8kg. There was little emphasis on postpartum weight or weight-loss advice with 14.1% of women reporting having received weight advice compared with physical activity (51.9%) and dietary (47.5%) advice. Women were more likely to have received weight advice during pregnancy than following childbirth (54.5% vs 5.8% respectively)(p<0.001). No association was found between provision of clinician advice regarding weight, physical activity or diet and postpartum BMI or PPWR.
Conclusion: Despite higher rates of overweight and obesity observed as a result of pregnancy weight gain, few women receive weight advice following childbirth. Supportive strategies to limit PPWR are needed to reduce the risk of maternal overweight and obesity.