Gestational Weight Gain And Postpartum Weight Retention-A Cohort Study From South India
Namita Patel, SubithaLakshminarayanan, Haritha Sagili, Jayaprakash Sahoo, BalasubramaniyanVairappan
JIPMER, Puducherry, India
Introduction
1.According to the World Health Organization (2021), 54% of women globally were overweight or obese.
2.Women in sub-Saharan Africa and South Asia gain <60% of the minimum gestational weight recommended by Institute of Medicine (IOM) guidelines for normal-weight women.
3.Postpartum weight retention has been reported to range from 35% to 91% across Indian studies, with significant proportions shifting to higher BMI categories and increased cardiometabolic risk.
Objectives
1.To estimate the prevalence of pre-pregnancy overweight/obesity, excessive gestational weight gain (GWG) at delivery, and postpartum weight retention at one year.
2.To identify factors associated with pre-pregnancy overweight/obesity, excessive GWG, and postpartum weight retention.
Study methods
•Design- Prospective cohort study
•Study Setting- Three Urban and three rural Primary Health Centres
•Study duration- May 2022- April 2024
•Sample size & Sampling- 465 enrolled consecutively
Study population- Pregnant women in first trimester (<14 weeks)
Exclusion criteria- Overt diabetic and hypertensive women, twin pregnancy
Procedure-
Data collected on socio-demographic characteristics, maternal anthropometry, and pregnancy outcomes
Followed up at delivery (N=408, 87.7%), 12th month postpartum (N=386, 83%)
Total weight gain= Weight recorded at admission for labor- baseline weight
Postpartum weight retention= Weight at one year postpartum - baseline weight
IOM Guidelines- Recommended weight gain
ØNormal weight: 11–16 kg,
ØUnderweight: 13–18 kg
ØOverweight : 7–11 kg
ØObese: 5-9 kg
Data analysis- EpiData 3.1 and STATA 17
Multivariable linear regression and log-binomial regression
Results
•Mean Age - 26.4 ± 3.8 years
•Urban – 71% (N=330)
•Primigravida - 52.3% (N=243)
Nulliparous – 58.1% (270)
Advanced maternal age was a significant predictor of higher BMI (aPR = 1.5, 95% CI: 1.1–2.0, p = 0.004), after adjusting for other variables.
Gestational Weight Gain
•Mean GWG- 10.1± 4.5 kg
•Inadequate GWG- 48.5%
•Adequate GWG- 32.4%
•Excessive GWG – 19.1%
Pospartum weight retention
Higher socioeconomic status (aPR = 1.26, 95% CI: 1.06–1.50), pre-pregnancy BMI (aPR = 1.03, 95% CI: 1.02–1.05), and GWG (aPR = 1.04, 95% CI: 1.03–1.06) were significant predictors of PPWR.
Discussion
•REVAMP Cohort- Mean GWG of 11.6 kg
•Garbh-Ini Cohort- Median GWG of 7.86 kg
•SRMA, India- Excessive GWG of 16.5%
•RAHMA cohort - 35% retained over 7 kg
Conclusion
•Half of the women were overweight or obese, two-thirds had GWG outside the recommended guidelines, and two-thirds had PPWR.
•Pre-conception weight management, promotion of healthy habits during pregnancy, and routine post-delivery follow-ups to create awareness on lifestyle changes
References
1.Thiruvengadam R et al. Gestational weight gain trajectories in GARBH–Inipregnancy cohort in North India and a comparative analysis with global references. Eur J Clin Nutr. 2021;76(6):855–6.
