Low-income women's reproductive weight patterns empirically based clusters of prepregnant, gestational, and postpartum weights.
BACKGROUND
Women have varying weight responses to pregnancy and the postpartum period. The purpose of this study was to derive sub-groups of women based on differing reproductive weight clusters; to validate clusters by reference to adequacy of gestational weight gain (GWG) and postpartum incremental weight shifts; and to examine associations between clusters and demographic, behavioral, and psychosocial variables.


METHODS
A cluster analysis was conducted of a multi-ethnic/racial sample of low-income women (n = 247). Clusters were derived from three weight variables: prepregnant body mass index, GWG, and postpartum retained weight.


RESULTS
Five clusters were derived: Cluster 1, normal weight-high prenatal gain-average retain; cluster 2, normal weight-low prenatal gain-zero retain; cluster 3, high normal weight-high prenatal gain-high retain; cluster 4, obese-low prenatal gain-average retain; and cluster 5, overweight-very high prenatal gain-very high retain. Clusters differed with regard to postpartum weight shifts (p < .001), with clusters 3, 4, and 5, mostly gaining weight between 6 weeks and 12 months postpartum, whereas clusters 1 and 2 were losing weight. Clusters were also associated with race/ethnicity (p < .01), breastfeeding immediately postdelivery (p < .01), smoking at 12 months (p < .05), and reaching weight goals at 6 and 12 months (p < .001), but not depressive symptoms, fat intake habits, or physical activity.


CONCLUSIONS
In a five-cluster solution, postpartum weight shifts, ethnicity, and initial breastfeeding were among factors associated with clusters. Monitoring of weight and appropriate intervention beyond the 6 weeks after birth is needed for low-income women in high normal weight, overweight, and obese clusters.
Walker
Lorraine O
LO
School of Nursing, The University of Texas at Austin, Austin, Texas 78701, USA. lwalker@mail.nur.utexas.edu
D000328:Adult; D015992:Body Mass Index; D016000:Cluster Analysis; D005006:Ethnicity; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006801:Humans; D049590:Postpartum Period / Q000208:ethnology*; D011203:Poverty / Q000208:ethnology* / Q000706:statistics & numerical data; D011247:Pregnancy; D013781:Texas / Q000453:epidemiology; D013997:Time Factors; D015430:Weight Gain / Q000208:ethnology / Q000502:physiology*