Post-partum weight retention in Northeastern Brazilian women: a prospective NISAMI cohort study

ABSTRACT BACKGROUND: Weight retention during the post-partum period is associated with excessive weight gain. OBJECTIVES: To investigate factors associated with maternal weight retention at six months post-partum (PPWR). DESIGN AND SETTING: A prospective cohort study was conducted with 127 women monitored using prenatal services. METHODS: The outcome variable was represented by post-partum maternal weight retention and calculated as the difference between the mother’s weight at sixth month post-partum and her pregestational weight. RESULTS: The mean age of the pregnant women was 26.7 ± 5.25 years old, and the post-partum maternal weight retention was 46.5%. The proximal determinants showed a direct association with PPWR after adjusting for the distal and intermediate variables: excessive gestational weight gain (odds ratio [OR]:3.34; confidence interval [CI]:1.16–9.59), greater adhesion to dietary intake pattern 2 (composed of red meats and derivatives, eggs, industrialized foods, and coffee) (OR:2.70; CI:1.16–6.32), and the absence of exclusive maternal breastfeeding in the first month (OR:3.40; CI:1.27–9.12), as well as primiparity (OR:2.36; CI:1.00–5.55), an intermediate determinant. Insufficient weight gain in pregnancy was inversely associated with the outcome (OR:0.35; CI:0.31–0.93). CONCLUSIONS: Among the hierarchical determinants, proximal factors were interrelated with maternal weight retention, indicating that excessive total weight gain, an inadequate dietary intake pattern, and the absence of exclusive maternal breastfeeding in the first month of life work as dampeners of the return to pre-gestational weight. Prepartum and post-partum care interventions can contribute to reducing excess weight in women.