Abstract
Obesity has progressively become a global epidemic that constitutes one of the biggest current health problems worldwide. Pregnancy is a risk factor for excessive weight gain. Factors that may predict development of obesity in later life mainly include gestational weight gain, pre-pregnancy nutritional status, age, parity and race. Change in lifestyle factors, such as eating habits, enrollment in physical activity, smoking and duration of lactation, in addition to the above factors, may also contribute to the development of obesity but are still not fully understood. Women who retain more body weight after pregnancy have, in general, larger pregnancy body weight gain, higher pre-pregnancy body mass index, marked weight changes in previous pregnancies, lactate slightly less and stop smoking during pregnancy to a larger extent. In addition, irregular eating habits and decreased leisure time activity after delivery influence postpartum weight retention. Taking into consideration the epidemic of obesity, with all its adverse long-term consequences, there is an increasing need to promote counseling before, during and after pregnancy on the role of diet and physical activity in reproductive health.
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References
Branca F, Nikogosian H, Lobstein T . The Challenge of Obesity in the WHO European Region and the Strategies for Response: Summary. World Health Organization. Regional Office for Europe: Copenhagen, Denmark. Available at: http://www.euro.who.int/document/e89858.pdf 2007.
Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ . Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US adults. N Engl J Med 2003; 348: 1625–1638.
National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention. Prevalence of overweight and obesity among adults: United States. Available at: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/obese/obse99.htm Accessed on 14 July 2009.
Rössner S . Pregnancy, weight cycling and weight gain in obesity. Int J Obes Relat Metab Disord 1992; 16: 145–147.
Rossner S, Ohlin A . Pregnancy as a risk factor for obesity: lessons from the Stockholm Pregnancy and Weight Development Study. Obes Res 1995; 3 (Suppl 2): 267s–275s.
Williamson DF, Madans J, Pamuk E, Flegal KM, Kendrick JS, Serdula MK . A prospective study of childbearing and 10-year weight gain in US white women 25 to 45 years of age. Int J Obes Relat Metab Disord 1994; 18: 561–569.
Gunderson EP, Abrams B . Epidemiology of gestational weight gain and body weight changes after pregnancy. Epidemiol Rev 1999; 21: 261–275.
Rössner S . Weight gain in pregnancy. Hum Reprod 1997; 12 (Suppl 1): 110–115.
Cunningham FG, Gant NF, Leveno KJ, Gilstrap III LC, Hauth JC, Wenstrom HT . Williams Obstetrics. McGraw-Hill: New York, 2005.
Yogev Y, Catalano PM . Pregnancy and obesity. Obstet Gynecol Clin North Am 2009; 36: 285–300, viii.
Baeten JM, Bukusi EA, Lambe M . Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health 2001; 91: 436–440.
Cedergren MI . Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 2004; 103: 219–224.
Whitaker RC . Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy. Pediatrics 2004; 114: e29–e36.
Linne Y, Barkeling B, Rossner S . Long-term weight development after pregnancy. Obes Rev 2002; 3: 75–83.
Rooney BL, Schauberger CW, Mathiason MA . Impact of perinatal weight change on long-term obesity and obesity-related illnesses. Obstet Gynecol 2005; 106: 1349–1356.
Ohlin A, Rossner S . Maternal body weight development after pregnancy. Int J Obes 1990; 14: 159–173.
Harris HE, Ellison GT, Holliday M . Is there an independent association between parity and maternal weight gain? Ann Hum Biol 1997; 24: 507–519.
Parker JD, Abrams B . Differences in postpartum weight retention between black and white mothers. Obstet Gynecol 1993; 81: 768–774.
Keppel KG, Taffel SM . Pregnancy-related weight gain and retention: implications of the 1990 Institute of Medicine guidelines. Am J Public Health 1993; 83: 1100–1103.
Poppitt SD, Prentice AM, Jequier E, Schutz Y, Whitehead RG . Evidence of energy sparing in Gambian women during pregnancy: a longitudinal study using whole-body calorimetry. Am J Clin Nutr 1993; 57: 353–364.
Prentice AM, Goldberg GR, Davies HL, Murgatroyd PR, Scott W . Energy-sparing adaptations in human pregnancy assessed by whole-body calorimetry. Br J Nutr 1989; 62: 5–22.
Prentice AM, Goldberg GR . Energy adaptations in human pregnancy: limits and long-term consequences. Am J Clin Nutr 2000; 71: 1226S–1232S.
Prentice AM, Goldberg GR . Energy adaptations in human pregnancy: limits and long-term consequences. Am J Clin Nutr 2000; 71: 1226S–1232S.
Hytten F, Chamberlain G . Clinical Physiology in Obstetrics. Blackwell Scientific Publications: Oxford, 1980.
Rasmussen K, Yaktine A, Committee to Reexamine IOM Pregnancy Weight Guidelines; Institute of Medicine; National Research Council. Weight gain during pregnancy: reexamining the guidelines. The National Academies Press: Washington, DC, 2009.
Kac G, Benicio MH, Velasquez-Melendez G, Valente JG, Struchiner CJ . Gestational weight gain and prepregnancy weight influence postpartum weight retention in a cohort of Brazilian women. J Nutr 2004; 134: 661–666.
Muscati SK, Gray-Donald K, Koski KG . Timing of weight gain during pregnancy: promoting fetal growth and minimizing maternal weight retention. Int J Obes Relat Metab Disord 1996; 20: 526–532.
DeVader SR, Neeley HL, Myles TD, Leet TL . Evaluation of gestational weight gain guidelines for women with normal prepregnancy body mass index. Obstet Gynecol 2007; 110: 745–751.
Johnson JW, Longmate AJ, Frentzen B . Excessive maternal weight and pregnancy outcome. Am J Obstet Gynecol 1992; 167: 353–372.
Cedergren M . Effects of gestational weight gain and body mass index on obstetric outcome in Sweden. Int J Gynaecol Obstet 2006; 93: 269–274.
Olson CM, Strawderman MS, Reed RG . Efficacy of an intervention to prevent excessive gestational weight gain. Am J Obstet Gynecol 2004; 191: 530–536.
Butte NF, Wong WW, Treuth MS, Ellis KJ, O’Brian SE . Energy requirements during pregnancy based on total energy expenditure and energy deposition. Am J Clin Nutr 2004; 79: 1078–1087.
Forsum E . Energy requirements during pregnancy: old questions and new findings. Am J Clin Nutr 2004; 79: 933–934.
Butte NF, Ellis KJ, Wong WW, Hopkinson JM, Smith EO . Composition of gestational weight gain impacts maternal fat retention and infant birth weight. Am J Obstet Gynecol 2003; 189: 1423–1432.
Sohlstrom A, Forsum E . Changes in adipose tissue volume and distribution during reproduction in Swedish women as assessed by magnetic resonance imaging. Am J Clin Nutr 1995; 61: 287–295.
Schieve LA, Cogswell ME, Scanlon KS . Trends in pregnancy weight gain within and outside ranges recommended by the Institute of Medicine in a WIC population. Matern Child Health J 1998; 2: 111–116.
Walker LO, Sterling BS, Timmerman GM . Retention of pregnancy-related weight in the early postpartum period: implications for women's health services. J Obstet Gynecol Neonatal Nurs 2005; 34: 418–427.
Scholl TO, Hediger ML, Schall JI, Ances IG, Smith WK . Gestational weight gain, pregnancy outcome, and postpartum weight retention. Obstet Gynecol 1995; 86: 423–427.
Lawrence M, McKillop FM, Durnin JV . Women who gain more fat during pregnancy may not have bigger babies: implications for recommended weight gain during pregnancy. Br J Obstet Gynaecol 1991; 98: 254–259.
Rode L, Hegaard HK, Kjaergaard H, Moller LF, Tabor A, Ottesen B . Association between maternal weight gain and birth weight. Obstet Gynecol 2007; 109: 1309–1315.
Greene GW, Smiciklas-Wright H, Scholl TO, Karp RJ . Postpartum weight change: how much of the weight gained in pregnancy will be lost after delivery? Obstet Gynecol 1988; 71: 701–707.
Frischknecht F, Bruhwiler H, Raio L, Luscher KP . Changes in pre-pregnancy weight and weight gain during pregnancy: retrospective comparison between 1986 and 2004. Swiss Med Wkly 2009; 139: 52–55.
Rooney BL, Schauberger CW . Excess pregnancy weight gain and long-term obesity: one decade later. Obstet Gynecol 2002; 100: 245–252.
Amorim AR, Rossner S, Neovius M, Lourenco PM, Linne Y . Does excess pregnancy weight gain constitute a major risk for increasing long-term BMI? Obesity (Silver Spring) 2007; 15: 1278–1286.
Schmitt NM, Nicholson WK, Schmitt J . The association of pregnancy and the development of obesity - results of a systematic review and meta-analysis on the natural history of postpartum weight retention. Int J Obes (London) 2007; 31: 1642–1651.
Institute of Medicine, Food and Nutrition Board. Nutrition During Pregnancy, Weight Gain and Nutrient Supplements. National Academy Press: Washington, DC, 1990.
Gunderson EP, Abrams B, Selvin S . Does the pattern of postpartum weight change differ according to pregravid body size? Int J Obes Relat Metab Disord 2001; 25: 853–862.
Eastman NJ, Jackson E . Weight relationships in pregnancy. I. The bearing of maternal weight gain and pre-pregnancy weight on birth weight in full term pregnancies. Obstet Gynecol Surv 1968; 23: 1003–1025.
Niswander KR, Singer J, Westphal Jr M, Weiss W . Weight gain during pregnancy and prepregnancy weight. Association with birth weight of term gestation. Obstet Gynecol 1969; 33: 482–491.
FAO. Food and Nutrition Technical Report Series. Human Energy Requirements. Report of a Joint FAO/WHO/UNU Expert Consultation: FAO, Rome, 17–24 October 2001.
Watkins ML, Rasmussen SA, Honein MA, Botto LD, Moore CA . Maternal obesity and risk for birth defects. Pediatrics 2003; 111: 1152–1158.
Cnattingius S, Bergstrom R, Lipworth L, Kramer MS . Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med 1998; 338: 147–152.
Young TK, Woodmansee B . Factors that are associated with cesarean delivery in a large private practice: the importance of prepregnancy body mass index and weight gain. Am J Obstet Gynecol 2002; 187: 312–318.
Bhattacharya S, Campbell DM, Liston WA, Bhattacharya S . Effect of body mass index on pregnancy outcomes in nulliparous women delivering singleton babies. BMC Public Health 2007; 7: 168.
Robinson HE, O’Connell CM, Joseph KS, McLeod NL . Maternal outcomes in pregnancies complicated by obesity. Obstet Gynecol 2005; 106: 1357–1364.
Rosso P . A new chart to monitor weight gain during pregnancy. Am J Clin Nutr 1985; 41: 644–652.
Simpson JW, Lawless RW, Mitchell AC . Responsibility of the obstetrician to the fetus. II. Influence of prepregnancy weight and pregnancy weight gain on birthweight. Obstet Gynecol 1975; 45: 481–487.
Jelliffe DB . The assessment of the nutritional status of the community (with special reference to field surveys in developing regions of the world). Monogr Ser World Health Organ 1966; 53: 3–271.
Walker LO . Predictors of weight gain at 6 and 18 months after childbirth: a pilot study. J Obstet Gynecol Neonatal Nurs 1996; 25: 39–48.
Li C, Goran MI, Kaur H, Nollen N, Ahluwalia JS . Developmental trajectories of overweight during childhood: role of early life factors. Obesity (Silver Spring) 2007; 15: 760–771.
Smith DE, Lewis CE, Caveny JL, Perkins LL, Burke GL, Bild DE . Longitudinal changes in adiposity associated with pregnancy. The CARDIA Study. Coronary Artery Risk Development in Young Adults Study. JAMA 1994; 271: 1747–1751.
Billewicz WZ, Thomson AM . Body weight in parous women. Br J Prev Soc Med 1970; 24: 97–104.
Chu SY, Callaghan WM, Bish CL, D’Angelo D . Gestational weight gain by body mass index among US women delivering live births, 2004-2005: fueling future obesity. Am J Obstet Gynecol 2009; 200: 271–277.
Segel JS, McAnarney ER . Adolescent pregnancy and subsequent obesity in African-American girls. J Adolesc Health 1994; 15: 491–494.
Gunderson EP, Abrams B, Selvin S . The relative importance of gestational gain and maternal characteristics associated with the risk of becoming overweight after pregnancy. Int J Obes Relat Metab Disord 2000; 24: 1660–1668.
Abrams B . Prenatal weight gain and postpartum weight retention: a delicate balance. Am J Public Health 1993; 83: 1082–1084.
Boardley DJ, Sargent RG, Coker AL, Hussey JR, Sharpe PA . The relationship between diet, activity, and other factors, and postpartum weight change by race. Obstet Gynecol 1995; 86: 834–838.
Williamson DF, Kahn HS, Byers T . The 10-y incidence of obesity and major weight gain in black and white US women aged 30–55 y. Am J Clin Nutr 1991; 53: 1515S–1518S.
Jensen EX, Fusch C, Jaeger P, Peheim E, Horber FF . Impact of chronic cigarette smoking on body composition and fuel metabolism. J Clin Endocrinol Metab 1995; 80: 2181–2185.
Ferrara CM, Kumar M, Nicklas B, McCrone S, Goldberg AP . Weight gain and adipose tissue metabolism after smoking cessation in women. Int J Obes Relat Metab Disord 2001; 25: 1322–1326.
Filozof C, Fernandez Pinilla MC, Fernandez-Cruz A . Smoking cessation and weight gain. Obes Rev 2004; 5: 95–103.
Rössner S . Cessation of cigarette smoking and body weight increase. Acta Med Scand 1986; 219: 1–2.
Frigerio C, Schutz Y, Prentice A, Whitehead R, Jequier E . Is human lactation a particularly efficient process? Eur J Clin Nutr 1991; 45: 459–462.
Janney CA, Zhang D, Sowers M . Lactation and weight retention. Am J Clin Nutr 1997; 66: 1116–1124.
Kramer FM, Stunkard AJ, Marshall KA, McKinney S, Liebschutz J . Breast-feeding reduces maternal lower-body fat. J Am Diet Assoc 1993; 93: 429–433.
Dewey KG, Heinig MJ, Nommsen LA . Maternal weight-loss patterns during prolonged lactation. Am J Clin Nutr 1993; 58: 162–166.
Johnston EM . Weight changes during pregnancy and the postpartum period. Prog Food Nutr Sci 1991; 15: 117–157.
Potter S, Hannum S, McFarlin B, Essex-Sorlie D, Campbell E, Trupin S . Does infant feeding method influence maternal postpartum weight loss? J Am Diet Assoc 1991; 91: 441–446.
Dewey KG . Impact of breastfeeding on maternal nutritional status. Adv Exp Med Biol 2004; 554: 91–100.
Prentice AM, Prentice A . Energy costs of lactation. Annu Rev Nutr 1988; 8: 63–79.
American Dietetic Association; American Society of Nutrition Siega-Riz AM, King JC . Position of the American Association and American Society for Nutrition: obesity, reproduction, and pregnancy outcomes. J Am Diet Assoc 2009; 109: 918–927.
Ohlin A, Rossner S . Trends in eating patterns, physical activity and socio-demographic factors in relation to postpartum body weight development. Br J Nutr 1994; 71: 457–470.
Lof M, Hilakivi-Clarke L, Sandin S, Weiderpass E . Effects of pre-pregnancy physical activity and maternal BMI on gestational weight gain and birth weight. Acta Obstet Gynecol Scand 2008; 87: 524–530.
Mottola MF . Exercise prescription for overweight and obese women: pregnancy and postpartum. Obstet Gynecol Clin North Am 2009; 36: 301–316, viii.
Stuebe AM, Oken E, Gillman MW . Associations of diet and physical activity during pregnancy with risk for excessive gestational weight gain. Am J Obstet Gynecol 2009; 201: 58.
Lyznicki JM, Young DC, Riggs JA, Davis RM . Obesity: assessment and management in primary care. Am Fam Physician 2001; 63: 2185–2196.
Leser MS, Yanovski SZ, Yanovski JA . A low-fat intake and greater activity level are associated with lower weight regain 3 years after completing a very-low-calorie diet. J Am Diet Assoc 2002; 102: 1252–1256.
Walker LO . Managing excessive weight gain during pregnancy and the postpartum period. J Obstet Gynecol Neonatal Nurs 2007; 36: 490–500.
Polley BA, Wing RR, Sims CJ . Randomized controlled trial to prevent excessive weight gain in pregnant women. Int J Obes Relat Metab Disord 2002; 26: 1494–1502.
Grace SL, Williams A, Stewart DE, Franche RL . Health-promoting behaviors through pregnancy, maternity leave, and return to work: effects of role spillover and other correlates. Women Health 2006; 43: 51–72.
Kinnunen TI, Pasanen M, Aittasalo M, Fogelholm M, Hilakivi-Clarke L, Weiderpass E et al. Preventing excessive weight gain during pregnancy—a controlled trial in primary health care. Eur J Clin Nutr 2007; 61: 884–891.
Olson CM . Achieving a healthy weight gain during pregnancy. Annu Rev Nutr 2008; 28: 411–423.
Leermakers EA, Anglin K, Wing RR . Reducing postpartum weight retention through a correspondence intervention. Int J Obes Relat Metab Disord 1998; 22: 1103–1109.
Amorim AR, Linne YM, Lourenco PM . Diet or exercise, or both, for weight reduction in women after childbirth. Cochrane Database Syst Rev 2007. CD005627.
Lovelady CA, Stephenson KG, Kuppler KM, Williams JP . The effects of dieting on food and nutrient intake of lactating women. J Am Diet Assoc 2006; 106: 908–912.
Amorim Adegboye AR, Linne YM, Laurenco PMC . Diet or exercise, or both, for weight reduction in women after childbirth. Cochrane Database Syst Rev 2007. (3): CD005627. DOI: 10 1002/14651858 CD005627 pub2 2007.
American College of Sports Medicine. ACSM's Guidelines for Exercise Testing and Prescription. Lippincott Williams & Wilkins: Philadelphia, PA, 2006.
Dewey KG . Effects of maternal caloric restriction and exercise during lactation. J Nutr 1998; 128: 386S–389S.
McCrory MA, Nommsen-Rivers LA, Mole PA, Lonnerdal B, Dewey KG . Randomized trial of the short-term effects of dieting compared with dieting plus aerobic exercise on lactation performance. Am J Clin Nutr 1999; 69: 959–967.
Lovelady CA, Garner KE, Moreno KL, Williams JP . The effect of weight loss in overweight, lactating women on the growth of their infants. N Engl J Med 2000; 342: 449–453.
Dusdieker LB, Hemingway DL, Stumbo PJ . Is milk production impaired by dieting during lactation? Am J Clin Nutr 1994; 59: 833–840.
McCrory MA . Does dieting during lactation put infant growth at risk? Nutr Rev 2001; 59: 18–21.
Walker LO, Sterling BS, Kim M, Arheart KL, Timmerman GM . Trajectory of weight changes in the first 6 weeks postpartum. J Obstet Gynecol Neonatal Nurs 2006; 35: 472–481.
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Melzer, K., Schutz, Y. Pre-pregnancy and pregnancy predictors of obesity. Int J Obes 34 (Suppl 2), S44–S52 (2010). https://doi.org/10.1038/ijo.2010.239
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