title: Post-partum weight change patterns in the WHO Multicentre Growth Reference Study.
abstract: The interplay of factors that affect post-partum loss or retention of weight gained during pregnancy is not fully understood. The objective of this paper is to describe patterns of weight change in the six sites of the World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) and explore variables that explain variation in weight change within and between sites. Mothers of 1743 breastfed children enrolled in the MGRS had weights measured at days 7, 14, 28 and 42 post-partum, monthly from 2 to 12 months and bimonthly thereafter until 24 months post-partum. Height, maternal age, parity and employment status were recorded and breastfeeding was monitored throughout the follow-up. Weight change patterns varied significantly among sites. Ghanaian and Omani mothers lost little or gained weight post-partum. In Brazil, India, Norway and USA, mothers on average lost weight during the first year followed by stabilization in the second year. Lactation intensity and duration explained little of the variation in weight change patterns. In most sites, obese mothers tended to lose less weight than normal-weight mothers. In Brazil and Oman, primiparous mothers lost about 1 kg more than multiparous mothers in the first 6 months. In India and Ghana, multiparous mothers lost about 0.6 kg more than primiparas in the second 6 months. Culturally defined mother-care practices probably play a role in weight change patterns among lactating women. This hypothesis should stimulate investigation into gestational weight gain and post-partum losses in different ethnocultural contexts.
authors.affiliation: Department of Nutrition for Health and Development, World Health Organization, Geneva 27, Switzerland. onyangoa@who.int
authors.forename: Adelheid W
authors.initials: AW
authors.lastname: Onyango
authors.forename: Laurie
authors.initials: L
authors.lastname: Nommsen-Rivers
authors.forename: Amani
authors.initials: A
authors.lastname: Siyam
authors.forename: Elaine
authors.initials: E
authors.lastname: Borghi
authors.forename: Mercedes
authors.initials: M
authors.lastname: de Onis
authors.forename: Cutberto
authors.initials: C
authors.lastname: Garza
authors.forename: Anna
authors.initials: A
authors.lastname: Lartey
authors.forename: Anne
authors.initials: A
authors.lastname: Baerug
authors.forename: Nita
authors.initials: N
authors.lastname: Bhandari
authors.forename: Kathryn G
authors.initials: KG
authors.lastname: Dewey
authors.forename: Cora Luiza
authors.initials: CL
authors.lastname: Araújo
authors.forename: Ali Jaffer
authors.initials: AJ
authors.lastname: Mohamed
authors.forename: Jan
authors.initials: J
authors.lastname: Van den Broeck
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001942:Breast Feeding / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007774:Lactation / Q000208:ethnology; D008137:Longitudinal Studies; D008429:Maternal Welfare / Q000208:ethnology; D050177:Overweight / Q000209:etiology; D049590:Postpartum Period; D015430:Weight Gain; D015431:Weight Loss; D014944:World Health Organization