title: Excessive gestational weight gain and postpartum weight retention among obese women.
abstract: OBJECTIVE
  To evaluate the incremental effect of weight gain above that recommended for term pregnancy (15 pounds) on postpartum weight retention at 1 year among obese women.
  
  
  METHODS
  In a retrospective cohort study, we identified 1,656 singleton gestations resulting in live births among obese women (body mass index at or above 30 kg/m) between January 2000 and December 2005 in Kaiser Permanente Northwest. Pregnancy weight change (last available predelivery weight minus weight at pregnancy onset) was categorized as less than 0, 0-15, greater than 15 to 25, greater than 25 to 35, and greater than 35 pounds. Postpartum weight change (weight at 1 year postpartum minus weight at pregnancy onset) was defined as less than 0, 0-10, and greater than 10 pounds.
  
  
  RESULTS
  Total gestational weight gain was -33.2 (weight loss) to +98.0 pounds (weight gain). Nearly three fourths gained greater than 15 pounds, and they were younger and weighed less at baseline than women who gained 15 pounds or less. Pregnancy-related weight change showed a significant relationship with postpartum weight change. For each pound gained during pregnancy, there was a 0.4-pound increase above baseline weight at 1 year postpartum. In adjusted logistic regression models, the risk of a postpartum weight greater than 10 pounds over baseline was twofold higher for women gaining greater than 15 to 25 pounds compared with women gaining 0-15 pounds (odds ratio [OR] 2.18, 95% confidence interval [CI] 1.54-3.10), fourfold higher for women gaining greater than 25 to 35 pounds (OR 3.91, 95% CI 2.75-5.56), and almost eightfold higher for women gaining greater than 35 pounds (OR 7.66, 95% CI 5.36-10.97).
  
  
  CONCLUSIONS
  Incremental increases in gestational weight gain beyond the current recommendation for obese women substantially increase the risk of weight retention at 1 year postpartum.
  
  
  METHODS
  II.
authors.affiliation: From the Center for Health Research, Northwest/Hawaii/Southeast, Kaiser Permanente Northwest, Portland, Oregon; and Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Vesco
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Dietz
authors.forename: Joanne
authors.initials: J
authors.lastname: Rizzo
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Stevens
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Perrin
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Bachman
authors.forename: William M
authors.initials: WM
authors.lastname: Callaghan
authors.forename: F Carol
authors.initials: FC
authors.lastname: Bruce
authors.forename: Mark C
authors.initials: MC
authors.lastname: Hornbrook
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D016017:Odds Ratio; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D012189:Retrospective Studies; D015430:Weight Gain