The Influence Of Gestational Weight Gain On Postpartum Weight Retention

Objective: To research the gestational weight gain and 1-year postpartum weight retention of women of Wuhan and discuss the influence of pre-pregnancy body mass index and gestational weight gain on postpartum weight retention,providing theoretical basis of weight management for pregnant and postpartum women.Methods: Healthy single pregnant women who had been in the maternal and child queue of Tongji,1758 women in total.The objects of study were inquired their pre-pregnancy weight when they came in the maternal and child queue and measured their height with 8-16 w gestational age.Pregnant women were divided into three groups.The calculation method of gestational weight gain is using the latest weight before delivery minus the pre-pregnant weight.The gestational weight gain is divided into 3 groups—inadequate,adequate and excessive group according to the standard of gestational weight gain recommended by IOM(Institute of Medicine).The calculation method of weight retention 1 year postpartum is using the latest weight 1 year postpartum minus the pre-pregnancy weight,which is divided into 2 groups—<5 ?and ?5 ?.Analyze the influence of different pre-pregnancy BMI groups on gestational weight retention and analyze the influence of different gestational weight gain groups on weight retention 1-year postpartum.Multivariate groups of measurement data is compared by analysis of variance,and Student-Newman-Keuls will be used when we compare every two of all groups.Eumeration data is compared by chi-square test or Fisher's exact test.Results: The comparison of gestational weight gain of different pre-pregnancy BMI groups: The average GWG(16.26kg)of normal weight women is more than that(14.06kg)in overweight and obesity group;The BMI groups also had significant different patterns of GWG category according to IOM recommendations.The proportion of overweight and obesity women(67.8%)with excessive GWG is higher than normal weight group(48.6%).The differences above were statistically significant(P<0.05).The comparison of weight retention 1-year postpartum of different GWG groups: Weight retention was considerably greater(3.37kg)in women who gained more than the recommended amount and lower(0.48kg)in women who gained less than the recommended amount during pregnancy(P<0.05);The proportion(37.4%)of 1-year excessive PPWR in excessive GWG group are higher than that(25.7%)in adequate GWG group.The proportion(14.7%)of 1-year excessive PPWR in inadequate GWG group is lower than that(25.7%)in adequate GWG group.The differences above were statistically significant(P<0.05).The unadjusted OR of excessive PPWR is 1.73(95%CI:1.39~2.15)among excessive GWG women and 0.50(95%CI:0.34~0.74)among inadequate GWG women compared with adequate GWG women.After adjusting all the confounding factors mentioned in the paper,the adjusted OR of excessive PPWR is 1.80(95%CI:1.42~2.29)among excessive GWG women and 0.50(95%CI:0.32~0.74)among inadequate GWG women compared with adequate GWG women.Conclusions: The proportion of pregnant women who had gained excessive weight during pregnancy was 46.2% and the proportion of 1-year excessive PPWR was 29.6%.Compared with pre-pregnancy normal weight group,the incidence of excessive weight gain during pregnancy in pre-pregnancy overweight and obesity group grows.The excessive gestational weight gain would increase the risk of weight retention of 5kg or more apparently.Pregnant women should focus more on weight management during pregnancy so as to decrease the risk of weight retention 1 year postpartum.