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Lactation in Relation to Long-Term Maternal Weight Gain in African-American Women.

ABSTRACT: We assessed the relationship of lactation to long-term maternal weight gain among African-American women, who have a lower prevalence of lactation and a higher prevalence of obesity than other US women. A pregnancy cohort of 3,147 African-American women from the Black Women's Health Study who gave birth for the first time between 1995 and 2003 was followed for 8 years postpartum. Participants provided data on weight, lactation, gestational weight gain, education, diet, and exercise. Mean differences in weight gain were estimated in multivariable models. Overall, lactation was not associated with mean weight gain. However, the association was modified by prepregnancy body mass index (BMI; weight (kg)/height (m)2) (P for interaction=0.03): Among women with BMI<30 prior to the pregnancy, mean weight gain decreased with increasing months of lactation (P for trend<0.01), whereas among obese women (BMI?30), mean weight gain increased with increasing duration of lactation (P for trend=0.04). Adjusted mean differences for ?12 months of lactation relative to no lactation were -1.56 kg (95% confidence interval: -2.50, -0.61) among nonobese women and 2.33 kg (95% confidence interval: -0.35, 5.01) among obese women. The differences in postpartum mean weight gain persisted over the 8-year study period. Residual confounding by factors more common in women who breastfeed longer may have influenced the results.

SUBMITTER: Palmer JR

PROVIDER: S-EPMC4462338 | biostudies-literature | 2015 Jun

REPOSITORIES: biostudies-literature

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Lactation in Relation to Long-Term Maternal Weight Gain in African-American Women.

Palmer Julie R JR Kipping-Ruane Kristen K Wise Lauren A LA Yu Jeffrey J Rosenberg Lynn L

American journal of epidemiology 20150505 12

We assessed the relationship of lactation to long-term maternal weight gain among African-American women, who have a lower prevalence of lactation and a higher prevalence of obesity than other US women. A pregnancy cohort of 3,147 African-American women from the Black Women's Health Study who gave birth for the first time between 1995 and 2003 was followed for 8 years postpartum. Participants provided data on weight, lactation, gestational weight gain, education, diet, and exercise. Mean differe ...[more]

PMID: 25944887

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Project description:BackgroundPhthalates are endocrine disrupting chemicals that may influence weight status; however, few studies have considered weight gain during pregnancy and subsequent long-term weight changes in women.ObjectiveTo determine associations of prenatal phthalate exposure with maternal weight during pregnancy and through up to seven years post-delivery.MethodsWe analyzed 15 urinary phthalate biomarker concentrations during the 2nd and 3rd trimesters among 874 pregnant women enrolled in the Programming Research in Obesity, Growth Environment and Social Stress Study in Mexico City. We examined three time-specific maternal weight outcomes: gestational weight gain (between 2nd and 3rd trimesters), short-term weight (between 3rd trimester and 12 months post-delivery), and long-term weight (between 18 months and 6-7 years post-delivery). We used Bayesian Kernel Machine Regression (BKMR) to estimate associations for the total phthalate mixture, as well as multivariable linear mixed models for individual phthalate biomarkers.ResultsAs a mixture, 2nd trimester urinary phthalate biomarker concentrations were associated with somewhat lower gestational weight gain between the 2nd and 3rd trimesters (interquartile range, IQR, difference: -0.07 standard deviations, SD; 95% credible interval, CrI: -0.20, 0.06); multivariable regression and BKMR models indicated that this inverse association was primarily driven by mono-2-ethyl-5-carboxypentyl terephthalate (MECPTP). Prenatal (2nd and 3rd trimesters) urinary phthalate mixture concentrations were positively associated with maternal weight change through 12 months postpartum (IQR difference: 0.11 SD; 95% CrI: 0.00, 0.23); these associations persisted from 18 months to 6-7 years follow-up (IQR difference: 0.07 SD; 95% CrI: 0.04, 0.10). Postpartum weight changes were associated with mono-3-carboxypropyl phthalate (MCPP) and MECPTP.ConclusionsPrenatal phthalate exposure was inversely associated with gestational weight gain and positively associated with long-term changes in maternal weight. Further investigation is required to understand how phthalates may influence body composition and whether they contribute to the development of obesity and other cardiometabolic diseases in women.

Project description:BACKGROUND:Phthalates are known endocrine disruptors and peroxisome proliferator-activated receptor (PPAR) activators, potentially capable of promoting an obesogenic effect. Pregnant women are especially vulnerable to phthalate exposure due to physiological and metabolic changes during pregnancy, including those related to the metabolism of xenobiotics. Phthalate exposure during pregnancy has been associated with early gestational weight gain, however, its effect on long-term weight gain remains unclear. The aim of the present study was to evaluate the association between phthalate exposure during pregnancy and long-term changes in weight among women. METHODS:Urinary phthalate concentrations, socioeconomic, anthropometry and information on diet and socioeconomic status were collected during pregnancy from 178 women from the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) birth cohort. Maternal body weight and diet information was also collected up to 5 times in the first year postpartum and twice during follow-up visits 5.2-10.7 years later. A path analysis was performed to assess associations between urinary phthalate metabolite levels during pregnancy and change in weight (kg) per year after delivery, including age, education, living with/without partner, parity, daily energy intake and breastfeeding duration. RESULTS:The mean age at pregnancy was 27.3?±?5.9 years and mean body mass index during the first postpartum year was 27.07?±?4.22?kg/m2. On average, women gained 3.48?kg (0.52?±?0.84?kg/year). A unit increase in log-transformed mono-3-carboxypropyl phthalate (MCPP) was associated with 0.33?kg (95% CI: 0.09, 0.56) higher weight gain per year, and mono-benzyl phthalate (MBzP) with 0.21?kg (95% CI: -0.38, -0.03) lower weight gain per year. CONCLUSION:Exposure to certain phthalates during pregnancy may be associated with long-term weight change in women. More studies on the effects of phthalate exposure during pregnancy on women's long-term health are required.

Project description:ObjectiveBoth excessive and inadequate gestational weight gain (GWG) are associated with adverse health outcomes for the woman and her child. Antidepressant use in pregnancy could affect GWG, based on evidence in nonpregnant women that some antidepressants may cause weight gain and others weight loss. Previous studies of antidepressant use and GWG were small with limited ability to account for confounding, including by maternal mental health status and severity. We assessed the association of antidepressant continuation in pregnancy with GWG among women using antidepressants before pregnancy.Study designOur retrospective cohort study included singleton livebirths from 2001 to 2014 within Kaiser Permanente Washington, an integrated health care system. Data were obtained from electronic health records and linked Washington State birth records. Among women with ≥1 antidepressant fill within 6 months before pregnancy, women who filled an antidepressant during pregnancy were considered "continuers;" women without a fill were "discontinuers." We calculated mean differences in GWG and relative risks (RR) of inadequate and excessive weight gain based on Institute of Medicine guidelines. Using inverse probability of treatment weighting with generalized estimating equations, we addressed differences in maternal characteristics, including mental health conditions.ResultsAmong the 2,887 births, 1,689 (59%) were to women who continued antidepressants in pregnancy and 1,198 (42%) were to discontinuers. After accounting for confounding, continuers had similar weight gain to those who discontinued (mean difference: 1.3 lbs, 95% confidence interval [CI]: -0.1 to 2.8 lbs) and similar risks of inadequate and excessive GWG (RR: 0.95, 95% CI: 0.80-1.14 and RR: 1.06, 95% CI: 0.98-1.14, respectively). Findings were comparable for specific antidepressants and trimesters of exposure.ConclusionWe did not find evidence that continuation of antidepressants in pregnancy led to differences in GWG.Key points· Antidepressant use is associated with weight change in nonpregnant populations.. · Prior evidence on whether antidepressant use in pregnancy affects gestational weight gain is sparse.. · We accounted for confounding by characteristics such as mental health conditions and their severity.. · We found no association between pregnancy antidepressant continuation and gestational weight gain..

Project description:Specific dietary and other lifestyle behaviors may affect the success of the straightforward-sounding strategy "eat less and exercise more" for preventing long-term weight gain.We performed prospective investigations involving three separate cohorts that included 120,877 U.S. women and men who were free of chronic diseases and not obese at baseline, with follow-up periods from 1986 to 2006, 1991 to 2003, and 1986 to 2006. The relationships between changes in lifestyle factors and weight change were evaluated at 4-year intervals, with multivariable adjustments made for age, baseline body-mass index for each period, and all lifestyle factors simultaneously. Cohort-specific and sex-specific results were similar and were pooled with the use of an inverse-variance-weighted meta-analysis.Within each 4-year period, participants gained an average of 3.35 lb (5th to 95th percentile, -4.1 to 12.4). On the basis of increased daily servings of individual dietary components, 4-year weight change was most strongly associated with the intake of potato chips (1.69 lb), potatoes (1.28 lb), sugar-sweetened beverages (1.00 lb), unprocessed red meats (0.95 lb), and processed meats (0.93 lb) and was inversely associated with the intake of vegetables (-0.22 lb), whole grains (-0.37 lb), fruits (-0.49 lb), nuts (-0.57 lb), and yogurt (-0.82 lb) (P?0.005 for each comparison). Aggregate dietary changes were associated with substantial differences in weight change (3.93 lb across quintiles of dietary change). Other lifestyle factors were also independently associated with weight change (P<0.001), including physical activity (-1.76 lb across quintiles); alcohol use (0.41 lb per drink per day), smoking (new quitters, 5.17 lb; former smokers, 0.14 lb), sleep (more weight gain with <6 or >8 hours of sleep), and television watching (0.31 lb per hour per day).Specific dietary and lifestyle factors are independently associated with long-term weight gain, with a substantial aggregate effect and implications for strategies to prevent obesity. (Funded by the National Institutes of Health and others.).

Dataset Information

Lactation in Relation to Long-Term Maternal Weight Gain in African-American Women.

Publications

Lactation in Relation to Long-Term Maternal Weight Gain in African-American Women.

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