Excessive gestational weight gain is associated with long-term body fat and weight retention at 7 y postpartum in African American and Dominican mothers with underweight, normal, and overweight prepregnancy BMI.
BACKGROUND
Excessive gestational weight gain (GWG) is associated with postpartum weight retention (PPWR) and abdominal adiposity, but long-term effects are understudied in low-income and minority populations at high risk of obesity and associated sequelae.


OBJECTIVE
We examined associations between GWG and long-term PPWR and adiposity in a prospective cohort of African American and Dominican mothers in the Bronx and Northern Manhattan.


METHODS
Women (n = 302) were enrolled during pregnancy and were followed for 7 y postpartum. Linear regression was used to relate excessive GWG [greater than 2009 Institute of Medicine (IOM) guidelines] to outcomes [percentage body fat and long-term PPWR (change in weight from prepregnancy to 7 y postpartum)], adjusting for covariates and included an interaction term between prepregnancy body mass index (BMI; in kg/m(2)) and GWG.


RESULTS
Mean ± SD prepregnancy BMI and total GWG were 25.6 ± 5.8 (42% of women had BMI ≥25) and 16.6 ± 7.8 kg (64% of women had total GWG greater than IOM guidelines), respectively. Associations between GWG and long-term PPWR and the percentage body fat varied by prepregnancy BMI (P-interaction ≤ 0.06); excessive GWG was associated with a higher percentage body fat and greater long-term PPWR in mothers with lower prepregnancy BMI. To illustrate the interaction, a predicted covariate-adjusted model, which was used to derive estimates for the percentage body fat and PPWR associated with excessive GWG, was estimated for 2 prepregnancy BMI examples. For a woman with prepregnancy BMI of 22, excessive GWG was associated with 3.0% higher body fat (P < 0.001) and a 5.6-kg higher PPWR (P < 0.001); however, for a woman with a prepregnancy BMI of 30, excessive GWG was associated with 0.58% higher body fat (P = 0.55) and 2.06 kg PPWR (P = 0.24).


CONCLUSIONS
Long-term adiposity and PPWR in low-income African American and Dominican mothers were predicted by interacting effects of prepregnancy BMI and excessive GWG. The provision of support for mothers to begin pregnancy at a healthy weight and to gain weight appropriately during pregnancy may have important lasting implications for weight-related health in this population. This study was registered at clinicaltrials.gov as NCT00043498.
Institute of Human Nutrition, New York Obesity Research Center, Department of Medicine, and Departments of Epidemiology and ew2435@cumc.columbia.edu.
Elizabeth M
EM
Widen
Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY; and Columbia Center for Children's Environmental Health, Columbia University, New York, NY.
Robin M
RM
Whyatt
Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY; and Columbia Center for Children's Environmental Health, Columbia University, New York, NY.
Lori A
LA
Hoepner
Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY; and Columbia Center for Children's Environmental Health, Columbia University, New York, NY.
Judyth
J
Ramirez-Carvey
Division of Pediatric Endocrinology, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY; Columbia Center for Children's Environmental Health, Columbia University, New York, NY.
Sharon E
SE
Oberfield
Division of Pediatric Endocrinology, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY;
Abeer
A
Hassoun
Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY; and Columbia Center for Children's Environmental Health, Columbia University, New York, NY.
Frederica P
FP
Perera
Institute of Human Nutrition, New York Obesity Research Center, Department of Medicine, and.
Dympna
D
Gallagher
Departments of Epidemiology and Columbia Center for Children's Environmental Health, Columbia University, New York, NY.
Andrew G
AG
Rundle
D050154:Adiposity / Q000208:ethnology; D000293:Adolescent; D000328:Adult; D001741:Black or African American; D015992:Body Mass Index; D015331:Cohort Studies; D004293:Dominican Republic / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino; D006801:Humans; D059012:Lost to Follow-Up; D009519:New York City / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology* / Q000208:ethnology; D049590:Postpartum Period; D011203:Poverty; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000208:ethnology; D039401:Prenatal Nutritional Physiological Phenomena / Q000208:ethnology; D011446:Prospective Studies; D012008:Recurrence; D012306:Risk; D013851:Thinness / Q000453:epidemiology* / Q000208:ethnology; D015430:Weight Gain / Q000208:ethnology; D055815:Young Adult
African American; Dominican; body composition; body fat; gestational weight gain; maternal; maternal health; pregnancy; prepregnancy