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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.

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Potential variables for the reproductive success of beef cows were evaluated. Included in the model were the age of the cow at calving; the interval between the Julian calving date and the end of the breeding season; the body weight and conditions at calving, at 75 days post-partum and at the end of the breeding season; and the mean daily variation in weight between these dates. Logistic regression was used in the analysis, with the parameters evaluated using the odds ratio statistic, estimating the chance of pregnancy. The mean rate of pregnancy was 84% and 55% for early and late-weaned cows, respectively. For early weaned cows, the regression variables were the Julian calving date, age of the cow, weight gain from calving to 75 days post-partum, and from 75 days post-partum to the end of the reproductive period. For late-weaned cows, there were only two regression variables, weight at calving and weight gain from calving to the end of the reproductive period. For every year above the average age of the herd, early weaned cows have an 80.9% greater chance of pregnancy, while a reduction of one year reduces the chance of pregnancy by 44.7%. In early weaned cows, every seven days after the mean Julian calving date reduces the chances of pregnancy by 22.6%, whereas every seven days before the mean calving date increases pregnancy by 29.2%. Greater gains in cow body weight, from calving to the end of the reproductive period, determine a greater probability of pregnancy.

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This multicentric cohort study aimed to describe changes in dietary patterns during pregnancy and postpartum and the association with BMI variation at six and twelve months postpartum in women with gestational diabetes mellitus (GDM). Between 2014 and 2018, we enrolled women with GDM in prenatal clinics of the Brazilian National Health System and followed them for one year postpartum. The dietary patterns during pregnancy and the postpartum period were obtained by factorial analysis. The relationship between these patterns and variation in postpartum BMI was evaluated by Poisson regression with robust variance adjusted for confounders. We identified three dietary patterns in 584 women, two healthy (generally healthy and Dash type), which were associated with less weight gain (RR 0.77 CI 95% 0.62-0.96 and RR 0.71 CI 95% 0.57-0.88, respectively). The high-risk pattern (based on ultra-processed, high-calorie foods and sweetened drinks) was associated with weight gain (RR 1.31 CI 95% 1.07-1.61 and RR 1.26 CI 95% 1.01-1.59) in six and twelve months postpartum, respectively. Although the participants learned about healthy dieting during pregnancy, dietary habits worsened from pregnancy to postpartum, especially, with lower consumption of fruits and dairy and higher consumption of sweetened beverages, with consequent weight gain postpartum. Postpartum support is needed to prevent weight gain and obesity.

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Abstract Potential variables for the reproductive success of beef cows were evaluated. Included in the model were the age of the cow at calving; the interval between the Julian calving date and the end of the breeding season; the body weight and conditions at calving, at 75 days post-partum and at the end of the breeding season; and the mean daily variation in weight between these dates. Logistic regression was used in the analysis, with the parameters evaluated using the odds ratio statistic, estimating the chance of pregnancy. The mean rate of pregnancy was 84% and 55% for early and late-weaned cows, respectively. For early weaned cows, the regression variables were the Julian calving date, age of the cow, weight gain from calving to 75 days post-partum, and from 75 days post-partum to the end of the reproductive period. For late-weaned cows, there were only two regression variables, weight at calving and weight gain from calving to the end of the reproductive period. For every year above the average age of the herd, early weaned cows have an 80.9% greater chance of pregnancy, while a reduction of one year reduces the chance of pregnancy by 44.7%. In early weaned cows, every seven days after the mean Julian calving date reduces the chances of pregnancy by 22.6%, whereas every seven days before the mean calving date increases pregnancy by 29.2%. Greater gains in cow body weight, from calving to the end of the reproductive period, determine a greater probability of pregnancy.

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Abstract Objectives: to investigate the association between sociodemographic, gestational/puerperal factors and postpartum weight retention (PPWR) after 12 months in Brazilian women at a university hospital. Methods: prospective cohort with puerperal women recruited at the maternity ward of a university hospital in a Brazilian metropolis. At baseline (n=260), sociodemographic and anthropometric information on the mother-child binomial and data related to the gestational period were collected. Maternal dietary patterns were measured using a food frequency questionnaire and subsequently determined by Principal Component Analysis. Results: 75 women, with a mean age of 28.4 years (CI95%= 27.0-29.7), 25.3% with excessive PPPR, with an average of 3.6 kg (CI95%= 1.7) continued in the follow-up. -5.4). Higher gestational weight gain (GWG) (ß= 0.36; CI95%= 0.18-0.70) and lower maternal age (ß= -0.41; CI95%= -0.92--0.22) were PRPP predictors (p=0.001) (adjusted for per capita income, parity, type of delivery, number of prenatal visits, baby's birth weight, breastfeeding and physical activity). Conclusion: there was a high occurrence of excessive PPPR, favored by higher GPG and lower maternal age. This highlights the importance of monitoring women's health during the reproductive period, with guidance on ways of life (diet and physical activity), to favor better outcomes for mother-child.

Resumo Objetivos: investigar a associação entre fatores sociodemográficos, gestacionais/puerperais com a retenção de peso pós-parto (RPPP) após 12 meses em mulheres brasileiras em hospital universitário. Métodos: coorte prospectiva com puérperas recrutadas na maternidade do hospital universitário de uma metrópole brasileira. Na linha de base (n=260) foram coletadas informações sociodemográficas, antropométricas do binômio mãe-filho e dados relativos ao período gestacional. O padrão alimentar materno foi mensurado por meio do questionário de frequência alimentar e posteriormente determinado pela Análise de Componentes Principais. A RPPP foi classificada como risco para obesidade se ≥7,5Kg. Resultados: 75 mulheres continuaram no seguimento, com média de 28,4 anos de idade (IC95%= 27,0−29,7), 25,3% com RPPP excessiva, sendo em média 3,6 Kg (IC95%= 1,7−5,4). Maior ganho de peso gestacional (GPG) (β= 0,36; IC95%= 0,18-0,70) e menor idade materna (β= −0,41; IC95%= −0,92--0,22) foram preditores da RPPP (p≥0,001) (ajustado pela renda per capita, paridade, tipo de parto, número de consultas pré-natal, peso ao nascer do bebê, aleitamento materno e atividade física). Conclusão: evidenciou-se elevada ocorrência de RPPP excessiva, favorecida pelo maior GPG e menor idade materna. Aponta-se assim a importância do monitoramento da saúde da mulher durante o período reprodutivo, com orientações sobre modos de vida (alimentação e atividade física), para favorecer melhores desfechos para mãe-filho.

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OBJECTIVE: To evaluate the associations of pregestational BMI, gestational weight gain (GWG) and breast-feeding at 1 month postpartum with four patterns of weight change during the first year after delivery: postpartum weight retention (PPWR), postpartum weight gain (PPWG), postpartum weight retention + gain (PPWR + WG) and return to pregestational weight. DESIGN: In this secondary analysis of a prospective study, we categorised postpartum weight change into four patterns using pregestational weight and weights at 1, 6 and 12 months postpartum. We evaluated their associations with pregestational BMI, GWG and breast-feeding using multinomial logistic regression. Results are presented as relative risk ratios (RRR) and 95 % CI. SETTING: Mexico City. PARTICIPANTS: Women participating in the Programming Research in Obesity, Growth, Environment and Social Stressors pregnancy cohort. RESULTS: Five hundred women were included (53 % of the cohort). Most women returned to their pregestational weight by 1 year postpartum (57 %); 8 % experienced PPWR, 14 % PPWG and 21 % PPWR + WG. Compared with normal weight, pregestational overweight (RRR 2·5, 95 % CI 1·3, 4·8) and obesity (RRR 2·2, 95 % CI 1·0, 4·7) were associated with a higher risk of PPWG. Exclusive breast-feeding, compared with no breast-feeding, was associated with a lower risk of PPWR (RRR 0·3, 95 % CI 0·1, 0·9). Excessive GWG, compared with adequate, was associated with a higher risk of PPWR (RRR 3·3, 95 % CI 1·6, 6·9) and PPWR + WG (RRR 2·4, 95 % CI 1·4, 4·2). CONCLUSIONS: Targeting women with pregestational overweight or obesity and excessive GWG, as well as promoting breast-feeding, may impact the pattern of weight change after delivery and long-term women's health.

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BACKGROUND: Compared with women without polycystic ovary syndrome, women with polycystic ovary syndrome have a higher prevalence of cardiometabolic risk factors. Postpartum weight retention has been shown to contribute to these risks in the general population, but little is known about postpartum weight retention among women with polycystic ovary syndrome. OBJECTIVE: This study aimed to compare postpartum weight retention and peripartum weight trends between women with polycystic ovary syndrome and controls. STUDY DESIGN: Data on live, full-term singleton deliveries from January 1, 2014, to January 1, 2019, in women with and without polycystic ovary syndrome were abstracted from the electronic medical record. Weights during the pregestational period, pregnancy, and up to 12 months postpartum were collected. The primary outcome was likelihood of high postpartum weight retention of ≥5 kg above pregestational weight at 12 months after delivery. Secondary outcomes included the prevalence of high weight retention at other postpartum time points (6 weeks, 3 months, 6 months), absolute postpartum weight retention, gestational weight gain, and excess weight gain above the Institute of Medicine guidelines for weight gain in pregnancy. RESULTS: A total of 6333 women had the requisite weight information (pregestational, peak pregnancy, and at least 1 postpartum weight), including 429 (6.8%) with polycystic ovary syndrome. After adjusting for age, pregestational body mass index, race, gestational diabetes mellitus, and parity, women with polycystic ovary syndrome were less likely to be high weight retainers at 6 weeks after delivery (adjusted odds ratio, 0.71; P=.02). There was no difference in postpartum weight retention between groups at 3, 6, and 12 months after delivery. Overall, the prevalence of high weight retainers at 12 months after delivery was high in both groups (22.7% in polycystic ovary syndrome vs 29.2% in controls; P=.13), and there was no difference in absolute weight retention (1.69 kg in polycystic ovary syndrome vs 2.05 kg in controls; P=.25). Although women with polycystic ovary syndrome had a higher pregestational body mass index, they had lower gestational weight gain (median, 12.7 kg) than controls (median, 13.5 kg) (P=.01). These findings were driven by the group with obesity. The percentage of women who surpassed the Institute of Medicine guidelines for gestational weight gain based on the body mass index category was similar between groups (43.4% in polycystic ovary syndrome vs 47.3% in controls; P=.12). Overall, 18.5% of women with polycystic ovary syndrome and 23.4% of controls had a higher body mass index category at 12 months after delivery than before pregnancy. CONCLUSION: Women with polycystic ovary syndrome had lower gestational weight gain and lower likelihood of high weight retention at 6 weeks after delivery but similar weight retention at 12 months after delivery compared with controls. Overall, the large proportion of women with high postpartum weight retention highlights the importance of the peripartum time period for weight management, particularly in this high-risk group predisposed to obesity and cardiometabolic disease.

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Introducción: El embarazo es una etapa de riesgo de obesidad persistente después del parto, entre otras causas, es secundario al estado nutricional al inicio del embarazo y a las ganancias de peso por encima de lo recomendado. Objetivo: Describir las ganancias de peso gestacionales por categorías nutricionales y su asociación con la retención de peso al año del parto. Métodos: Se realizó un estudio observacional de corte transversal en 100 mujeres al año del parto, pertenecientes a tres áreas de salud del municipio Santa Clara, en el periodo comprendido de julio 2016 a julio 2017. Se revisaron los tarjetones de las embarazadas para recoger el peso en kg a la captación, su evaluación nutricional según el índice de masa corporal en la primera consulta y el peso al final de la gestación. Las mismas fueron visitadas en su domicilio al año de paridas; se recogieron datos generales, se midió la talla de pie, el peso corporal y la circunferencia de la cintura. Se calcularon los índices de masa corporal y cintura/talla. Resultados: Predominó la condición de peso adecuado a la captación (67,08 por ciento). El 82,87 por ciento de las mujeres retuvo peso al año de paridas; con mayor frecuencia en las obesas (90,0 por ciento) y sobrepeso (83,01 por ciento) según su estado nutricional a la captación. Todas las mujeres tuvieron índice cintura/talla por encima de 0,50 al año de paridas. Conclusiones: Las mujeres con mayores ganancias por encima de lo recomendado, tienen menor capacidad de recuperación del peso corporal al año de paridas(AU)

Introduction: Pregnancy is a period of persistent obesity risk after delivery. Among other causes, it is secondary to the nutritional status at the beginning of pregnancy and to gaining weight above the recommended. Objective: To describe gestational weight gains by nutritional categories and their association with weight retention one year after delivery. Methods: An observational and cross-sectional study was conducted with 100 women one year after delivery and from three health areas of Santa Clara Municipality, in the period from July 2016 to July 2017. Their pregnancy identification cards were reviewed to collect their weight in kilograms at the time pregnancy was identified, nutritional evaluation based on the body mass index at the first office visit, and the weight at the end of pregnancy. They were paid home visits one year after delivery. General data were collected, foot size, body weight, and waist circumference were measured. Body mass and waist/height indexes were calculated. Results: The weight condition adequate to the time pregnancy was identified (67.08 percent). 82.87 percent of women retained weight one year after delivery, more frequently in obese (90.0 percent) and overweight (83.01 percent) women according to their nutritional status at the time pregnancy was identified. All women had waist/height index above 0.50 one year after delivery. Conclusions: Women with weight gains higher than recommended have less capacity to recover their body weight one year after delivery(AU)

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Background: The postpartum period may be a vulnerable life stage for a woman's cardiometabolic health. We examined associations of exposure to common endocrine-disrupting chemicals (EDCs) during pregnancy with weight from delivery through 1 year postpartum among 199 women in Mexico City. Materials and Methods: During each trimester of pregnancy, we collected a urine sample to assay bisphenol A (BPA), mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), monobenzyl phthalate (MBzP), mono-3-carboxypropyl phthalate (MCPP), mono-2-ethyl-5-carboxypentyl phthalate (MECPP), mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP), mono-2-ethylhexyl phthalate (MEHP), mono-2-ethyl-5-oxohexyl phthalate (MEOHP), and monoethyl phthalate (MEP). We calculated summary scores for di-2-ethylhexyl phthalate metabolites (ΣDEHP) and dibutyl phthalate metabolites (ΣDBP). We calculated the geometric mean of each EDC across pregnancy for use in the analysis. At delivery and three additional times during the first year postpartum, we measured the women's weight. We used mixed-effects linear regression models to estimate associations of each EDC with weight at delivery (kg) and weight change (kg/year) from delivery through 1 year postpartum. Covariates included urinary specific gravity, maternal age, parity, height, first trimester body mass index, and gestational age at enrollment. Results: Mean ± standard deviation weight change during the first postpartum year was -0.49 ± 4.04 kg. The EDCs were inversely associated with weight at delivery, but positively associated with weight change through 1 year postpartum. For example, each interquartile range of urinary ΣDEHP corresponded with 1.38 (95% confidence interval: 0.44-2.33) kg lower weight at delivery and 1.01 (0.41--1.61) kg/year slower rate of weight loss. We observed similar associations for other EDCs. Conclusions: Prenatal exposure to EDCs is associated with lower weight at delivery, but slower rate of weight loss through the first postpartum year.

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BACKGROUND: Postpartum weight trajectories and its implications on later cardiometabolic health are not entirely understood. OBJECTIVES: Our objectives were: 1) to characterize maternal weight trajectories from 1 to 24 mo postpartum, 2) to determine the association of prepregnancy BMI, gestational weight gain (GWG), and pregnancy behaviors with the trajectories, and 3) to evaluate the association of weight trajectories with BMI, waist circumference (WC), lipid profile, glucose, insulin resistance, blood pressure, and inflammatory markers at 3 y postpartum. METHODS: We studied 1359 mothers from the prospective cohort Project Viva. Using weights at 1, 6, 12, and 24 mo postpartum, we characterized weight trajectories using a latent class growth model. For objectives 2 and 3, we used multinomial logistic regression and multiple linear regression models, respectively. RESULTS: Around 85% of women fell into a trajectory of sustained weight loss (1-12 mo) + maintenance (12-24 mo) (reference), 5.7% followed a trajectory characterized by fast weight loss + slight gain, and 9.7% fell into a trajectory of little weight loss + slight gain. Prepregnancy overweight and obesity increased the odds of falling into the fast weight loss + slight gain trajectory, compared with the reference. Prepregnancy overweight [OR 1.57 (95% CI: 1.01, 2.46)] and a higher total GWG rate [3.69 (2.90, 4.68)] increased the odds of falling into the little weight loss + slight gain trajectory, whereas a higher Prudent dietary pattern score was protective [0.73 (0.54, 0.98)]. Women in this trajectory had higher BMI, WC, weight gain from prepregnancy, low-density lipoprotein cholesterol, and inflammatory markers at 3 y postpartum. CONCLUSIONS: Women following a trajectory of little weight loss + slight gain during the first 2 y postpartum had an adverse cardiometabolic profile 3 y after delivery. Targeting diet and GWG during pregnancy and facilitating postpartum weight loss could improve women's long-term health.

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