title: Determinants of postpartum weight variation in a cohort of adult women; a hierarchical approach.
abstract: BACKGROUND
  Retention of the weight gained during pregnancy or the weight gain postpartum has been associated with increased prevalence of obesity in women of childbearing age.
  
  
  OBJECTIVE
  To identify determinants of weight variation at 24 months postpartum in women from 2 towns in Bahia, Brazil.
  
  
  METHODS
  Dynamic cohort data of 325 adult women were collected for 24 months postpartum. Weight variation at 24 months postpartum was considered a response variable. Socioeconomic, demographic, reproductive, related with childbirth variables and lifestyle conditions were considered exposure variables. A linear mixed-effects regression model with a hierarchical approach was used for data analysis.
  
  
  RESULTS
  Suitable sanitary conditions in the household (2.175 kg; p = 0.001) and participation social programs for income transfer (1.300 kg; p = 0.018) contributed to weight gain in distal level of determinants, while at intermediate level, pre gestational overweight and surgical delivery had effects on postpartum weight, causing an average increase of 3.380 kg (p < 0.001) and loss of 2.451 kg (p < 0.001), respectively. At proximal level, a score point increase for breastfeeding yielded an average postpartum loss of 70 g (p = 0.002).
  
  
  CONCLUSIONS
  Our results indicate the need to promote weight control during and after pregnancy, encourage extended breastfeeding, and improve living conditions through intersectoral interventions.
authors.affiliation: Medicine and Health postgraduate program and School of Nutrition at Federal University of Bahia, Brazil. mcmsilva@ufba.br
authors.forename: Maria da Conceição
authors.initials: Mda C
authors.lastname: Monteiro da Silva
authors.forename: Ana
authors.initials: A
authors.lastname: Marlúcia Oliveira
authors.forename: Lucivalda
authors.initials: L
authors.lastname: Pereira Magalhães de Oliveira
authors.forename: Dra Nedja
authors.initials: DN
authors.lastname: Silva dos Santos Fonseca
authors.forename: Mônica Leila
authors.initials: ML
authors.lastname: Portela de Santana
authors.forename: Edgar
authors.initials: E
authors.lastname: de Araújo Góes Neto
authors.forename: Thomaz
authors.initials: T
authors.lastname: Rodrigues Porto da Cruz
mesh_terms: D000328:Adult; D001835:Body Weight; D005260:Female; D006801:Humans; D009765:Obesity / Q000517:prevention & control; D050177:Overweight / Q000517:prevention & control; D049590:Postpartum Period; D013997:Time Factors; D015430:Weight Gain; D055815:Young Adult