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Is there a causal effect of parity on body composition: a birth cohort study.

ABSTRACT: Non-communicable diseases are the leading cause of death, worldwide. Obesity is one of the factors that is associated with the development of such diseases. The role of reproductive factors on women body composition has been evaluated, but the findings are controversial. This study was aimed at assessing the association of parity with body composition among women.In 1982, the maternity hospital of Pelotas, a southern Brazilian city, were visited daily and all deliveries were identified. Those livebirths whose family lived in the urban area of the city have been prospectively followed (n?=?5914). In 2012-13, we tried to follow the whole cohort, the subjects were interviewed and examined. We evaluated the association of parity with the following body composition variables: body mass index, waist circumference and fat mass %. Estimates were adjusted for family income, skin color, maternal schooling, occupational status, alcohol, smoking, physical activity, and consumption of processed and ultraprocessed foods. All these analyses were replicated among the cohort men as a comparison. We also assessed whether duration of breastfeeding moderated the association.In the 2012-13 visit, 3701 subjects were evaluated (mean age of 30.2 years). In the present analysis, we included 1620 women and 1653 men. 33% of women were nulliparous and 48% of men were without children. Even after controlling for confounding, parous women had a BMI 0.96 kg/m2 (95% CI: 0.30; 1.62) higher than nulliparous and for men the regression coefficient was 0.79 kg/m2 (95% CI: 0.29; 1.29). Waist circumference was also higher among parous women. Among men, the association was not linear and the regression coefficients were lower than that observed among women [3.41 cm (95% CI: -0.91; 7.73) among men and 4.83 cm (95% CI: 2.43; 7.24) among women with more than 3 children when compared with those without children], but this difference was not statistically significant (interaction p value?=?0.58). Fat mass % was not associated with parity. Breastfeeding did not modify the association between parity and body composition.Parity was positively associated with body mass index and waist circumference among women. However, similar results among men suggest that there is no causal effect of parity.

SUBMITTER: Reis-Santos B

PROVIDER: S-EPMC5822479 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Is there a causal effect of parity on body composition: a birth cohort study.

Reis-Santos Bárbara B Barros Fernando C FC Horta Bernardo L BL

BMC public health 20180222 1

<h4>Background</h4>Non-communicable diseases are the leading cause of death, worldwide. Obesity is one of the factors that is associated with the development of such diseases. The role of reproductive factors on women body composition has been evaluated, but the findings are controversial. This study was aimed at assessing the association of parity with body composition among women.<h4>Methods</h4>In 1982, the maternity hospital of Pelotas, a southern Brazilian city, were visited daily and all d ...[more]

PMID: 29466972

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Project description:In light of the adverse outcomes for mothers and offspring related to maternal obesity, identification of subgroups of women at risk of prepregnancy obesity and its related-adverse issues is crucial for optimizing antenatal care. We aimed to identify sociodemographic factors and maternal and neonatal outcomes associated with prepregnancy obesity, and we tested the effect modification of parity on these associations.In 2012, 3368 mothers who had delivered in 136 randomly selected maternity wards were included just after birth in the French birth cohort, Epifane. Maternal height and weight before and at the last month of pregnancy were self-reported. Maternal and neonatal outcomes were collected in medical records. Prepregnancy Body Mass Index (pBMI) was classified into underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9) and obesity (?30.0). Since we found statistically significant interactions with parity, the multinomial logistic regression model estimating associations of pBMI class with sociodemographic characteristics and pregnancy outcomes was stratified on parity (1335 primiparous and 1814 multiparous).Before pregnancy, 7.6% of women were underweight, 64.2% were of normal weight, 18.0% were overweight and 10.2% were obese. Among the primiparous, maternal age of 25-29 years (OR = 2.09 [1.13-3.87]; vs. 30-34 years), high school level (OR = 2.22 [1.33-3.73]; vs. university level), gestational diabetes (OR = 2.80 [1.56-5.01]) and hypertensive complications (OR = 3.80 [1.83-7.89]) were independently associated with prepregnancy obesity. Among the multiparous, primary (OR = 6.30 [2.40-16.57]), junior high (OR = 2.89 [1.81-4.64]) and high school (OR = 1.86 [1.18-2.93]) education levels (vs. university level), no attendance at antenatal classes (OR = 1.77 [1.16-2.72]), excess gestational weight gain (OR = 1.82 [1.20-2.76]), gestational diabetes (OR =5.16 [3.15-8.46]), hypertensive complications (OR = 8.13 [3.97-16.64]), caesarean delivery (OR = 1.80 [1.18-2.77]) and infant birth weight ? 4 kg (OR = 1.70 [1.03-2.80]; vs. birth weight between 2.5 kg and 4 kg) were independently associated with prepregnancy obesity.Obesity before pregnancy is associated with a set of sociodemographic characteristics and adverse pregnancy outcomes that differ across parity groups. Such findings are useful for targeted health policies aimed at attaining healthy prepregnancy weight and organizing perinatal care.

Project description:BackgroundAlthough research has found associations between increasing number of children and higher body mass index (BMI), there has been limited research investigating the association with body composition despite abdominal fat being independently associated with cardiovascular and metabolic risk. Most existing research has focussed on women, but investigating the relationship in men can help distinguish biological effects of pregnancy from social pathways related to parenthood.MethodsUsing the MRC National Survey of Health and Development (NSHD) multiple regression models were applied to test associations between number of children and body composition at age 60-64 years (N = 2229) and body mass index (BMI) and waist circumference (WC) at ages 60-64 and 69 years (N = 2149).ResultsIn adjusted models, associations were observed between increasing numbers of children and increasing fat-adjusted lean mass index in women (p = 0.06). Among men, those with children had 0.59kg (95% CI: 0.15 to 1.02) greater lean mass index than those without and fat:lean mass ratio was greater in those with 4+ children because of their slightly higher mean fat mass. Weak evidence of a higher android:gynoid mass ratio among mothers (0.03, 95% CI: 0.00,0.06, p = 0.1) was observed with no associations with fat mass index,android or gynoid fat mass. Increasing parity in women was associated with increasing BMI at 60-64 years and, more strongly, with increasing BMI at 69 years. Associations among men were also observed more clearly with BMI at 69 years.ConclusionThere was little evidence of a consistent association between number of children and body composition in early old age. The strongest associations are observed for lean, rather than fat mass, and in men rather than women, suggesting little evidence of biological effects of pregnancy. The results indicate social pathways associated with parenthood are the likely underlying mechanisms, with suggestion of selection into parenthood among men.

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Is there a causal effect of parity on body composition: a birth cohort study.

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Is there a causal effect of parity on body composition: a birth cohort study.

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