Search Results (40)

Objectives: Prospective anthropometric data on how women above and below the Asian-specific BMI ≥ 23 kg/m² cut-off differ across the maternal continuum remain limited. Because these data were collected in 2017–2018, before Thailand’s 2022 adoption of the threshold in antenatal care, this study describes central adiposity indicators in two independent cohorts of Thai women as a pre-implementation baseline. Methods: In this descriptive longitudinal dual-cohort study at a tertiary centre in Northern Thailand, 192 women formed two independent cohorts: Cohort A (pregnancy, from 12 weeks’ gestation; n = 110) and Cohort B (delivery to 24 weeks postpartum; n = 82), with no woman in both. Women were stratified by pre-pregnancy BMI (<23 vs. ≥23 kg/m²). Waist-to-height ratio (WHtR, primary) and mid-upper arm circumference (MUAC, secondary) were measured at seven timepoints and validated against 3D body scanning (r = 0.92–0.99). Results: At 12 weeks’ gestation, the ≥23 kg/m² stratum had higher WHtR (0.58 vs. 0.49; d = 1.56) and MUAC (32.52 vs. 26.19 cm; d = 1.98; both p < 0.001). Postpartum, the <23 kg/m² stratum returned to WHtR < 0.50 by Week 8, whereas the ≥23 kg/m² stratum remained above 0.50 through 24 weeks (0.56 vs. 0.48; p < 0.001). Conclusions: The ≥23 kg/m² stratum showed higher central adiposity indicators from early pregnancy and, in the separate postpartum cohort, values that remained above 0.50 through 24 weeks. Because the cohorts comprised different women, these patterns are descriptive and cannot demonstrate within-woman retention. They nonetheless suggest the cut-off may identify women who could benefit from earlier antenatal and extended postpartum nursing assessment, pending confirmation in within-woman studies. Full article

Background: The prevalence of being overweight and of obesity among women of childbearing age is constantly increasing. Objectives: To analyze the critical periods and goals of women’s weight management from early pregnancy to 3 years postpartum. Methods: Women’s weight was tracked from the first trimester of pregnancy to 3 years postpartum. We calculated their gestational weight gain (GWG) and postpartum weight retention (PPWR), and used linear mixed models and logistic models to estimate weight change velocities and risk factors associated with overweight/obesity at 1–3 years postpartum. Results: The medians of pre-pregnancy BMI (pre-BMI) and GWG among the 641 participants were 20.1 kg/m² and 15.0 kg. Among women with pre-BMI < 24 kg/m², those with excessive GWG remained at higher weights within 1.5 years postpartum than those with appropriate GWG (p < 0.05). Women’s weight decreased from 42 days to 1 year postpartum (β = −0.31 for low pre-BMI, β = −0.24 for normal pre-BMI, both p < 0.05), and remained unchanged from 1 to 3 years (p > 0.05). The rate of being overweight/obese at one year postpartum was mainly associated with pre-pregnancy weight (as a continuous variable, aOR = 1.58, 95%CI: 1.44–1.74) and 1-year PPWR (aOR = 1.78, 95%CI: 1.48–2.15). Compared with women who maintained normal BMI, those who shifted to being overweight/obese had higher pre-BMI and 1-year PPWR (22.6 kg/m² vs. 20.3 kg/m², 7.0 kg vs. 1.0 kg, p < 0.01). Conclusions: Normal and relatively low pre-BMI (18.5–22.0 kg/m²) and less than 2.0 kg of 1-year PPWR are goals of women’s weight management. Full article

Gestational obesity, defined as obesity during pregnancy or a pre-pregnancy BMI ≥30, is a growing global health challenge with profound implications for both maternal and offspring health. This narrative review synthesizes current evidence on the mechanistic pathways by which maternal obesity affects pregnancy outcomes and intergenerational health trajectories. For mothers, gestational obesity increases the risk of gestational diabetes, hypertensive disorders, cesarean delivery, and postpartum weight retention. Offspring exposed to maternal obesity face higher risks of obesity, metabolic syndrome, cardiovascular disease, and neurodevelopmental disorders, many of which persist across the lifespan. The underlying mechanisms include metabolic dysregulation, insulin resistance, chronic inflammation, oxidative stress, and alterations in placental function. Epigenetic modifications, such as DNA methylation, histone changes, and non-coding RNA expression, play central roles in fetal programming, while maternal gut dysbiosis and alterations in breast milk microbiota further shape infant health outcomes. Importantly, maternal obesity not only influences pregnancy and early life but also perpetuates an intergenerational cycle of obesity and related comorbidities. Preventive strategies targeting preconception and prenatal health, combined with interventions to optimize lactation and maternal diet, may mitigate long-term risks. Future research should prioritize longitudinal and mechanistic studies to refine interventions aimed at disrupting the transmission of obesity-related disease across generations. Full article

Nutrition plays a crucial role during pregnancy and lactation, influencing maternal and infant health, as well as human milk (HM) composition. The Mediterranean diet (MED) is recognized worldwide as a well-established healthy dietary pattern. This narrative review aims to integrate and summarize observational and interventional studies investigating the association between the MED and outcomes across the mother–milk–infant triad. A literature search was conducted in the Cochrane, Google Scholar, and PubMed databases, and 22 studies that met the eligibility criteria were included into review. The included studies were categorized into maternal outcomes (n = 13), HM composition outcomes (n = 9), and infant outcomes (n = 3). This narrative review suggests that adherence to the MED may be associated with maternal psychological health and well-being, postpartum weight loss, glucose metabolism, and the fatty acid profile of HM. Moreover, the included studies exhibited notable methodological differences that hindered direct comparisons and limited the generalizability of the findings. Future research should adopt an integrated and standardized methodology for assessing MED adherence, HM collection, and infant outcomes, considering the mother–human milk–infant triad. Full article

Bioelectrical impedance analysis (BIA) has a wide range of applications. For over 25 years, it has primarily been utilized for assessing body composition. This method is non-invasive, portable, widely available, cost-effective, and user-friendly, offering the advantage of repeatability and minimal dependence on patient cooperation. BIA measures the impedance of the whole body, specifically the body’s resistance to alternating current. In postpartum women, who undergo significant physiological changes following childbirth, BIA can serve as a valuable diagnostic and monitoring tool. It is commonly employed to track body weight and fat reduction, and it facilitates the differentiation of fat mass, muscle mass, and body water content. This enables the customization of nutritional plans and the development of individualized training regimens tailored to the patient’s health status. Additionally, BIA aids in the assessment of hydration status, which is particularly critical during the postpartum period when women often experience fluid retention. Furthermore, optimal hydration is essential for lactation and maintaining favorable conditions for breastfeeding. BIA is also invaluable for evaluating nutritional status, micronutrient balance, and preventing both overweight and malnutrition. Moreover, BIA supports physical recovery by monitoring muscle mass, thereby assisting in the assessment of pelvic floor muscle regeneration following childbirth. Full article

Background: Proactively preventing postpartum weight retention (PPWR) is one of the effective intervention strategies to reduce the occurrence of obesity in women. Population studies have shown that serum folate levels are closely related to body weight. The regulation of folic acid on lipid metabolism has been fully confirmed in both in vivo and in vitro studies. For many years, folic acid supplementation has been widely used in periconceptional women due to its role in preventing fetal neural tube defects. However, whether folic acid supplementation prior to and throughout pregnancy exerts preventive effects on PPWR remains uncertain. This study aims to investigate the preventive effect of folic acid on PPWR in rats and further explore the underlying mechanisms. Methods: In this study, pregnant rats were administered one of the dietary schedules: control diet (CON), high-fat diet (HF), control diet combined with folic acid (FA) and high-fat diet combined with folic acid (HF + FA). Results: We discovered that folic acid supplementation inhibited high-fat diet-induced elevations in body weight, visceral fat weight, liver weight, hepatic lipid levels and serum lipid levels at 1 week post-weaning (PW). Western blot analysis showed that folic acid supplementation inhibited the expression of endoplasmic reticulum (ER) stress-specific proteins including GRP78, PERK, eIF2α, IRE1α, XBP1 and ATF6, subsequently decreasing the expression of proteins related to lipid synthesis including SREBP-1c, ACC1 and FAS. Conclusions: In conclusion, folic acid supplementation prior to and throughout pregnancy exerts preventive effects on high-fat diet-induced PPWR in rats, and the mechanism is associated with the inhibition of ER stress-mediated lipogenesis signaling pathways in the liver. Folic acid supplementation may serve as a potential strategy for preventing PPWR. In the future, the effectiveness of folic acid in PPWR prevention can be further verified by population studies. Full article

Postpartum women present a high risk of disordered eating behaviors, but the heterogeneity between groups was not identified. This cross-sectional study aimed to identify eating styles profiles in postpartum women and explore the correlates based on demographic characteristics and psychosocial factors. Questionnaires were administered to 507 Chinese postpartum women. Latent profile analysis (LPA) was conducted to identify eating styles profiles. Multinomial logistic regression was used to investigate the correlates of these profiles among postpartum women. The LPA identified three eating styles profiles: postpartum women with low emotional, external, and restrained eating (Profile 1, 6.9%); postpartum women with medium emotional, external, and restrained eating (Profile 2, 66.1%); and postpartum women with high emotional, external, and restrained eating (Profile 3, 27.0%). Compared to Profile 1, higher postpartum depression (PPD) and body mass index (BMI) were more likely to be associated with Profile 2 and Profile 3, whereas higher postpartum weight retention (PPWR) was more likely to be associated with Profile 1. Compared to Profile 2, higher PPD and BMI were more likely associated with Profile 3. Disordered eating behaviors in postpartum women with three eating styles were associated with BMI, PPD, and PPWR. This study can guide healthcare professionals in developing targeted interventions to improve maternal and child health globally. Full article

This study examines relationships between breastfeeding practices and postpartum weight retention (PPWR) at 6 and 12 months postpartum among 379 first-time mothers participating in a clinical trial in Singapore. We categorized feeding modes at 6 months into exclusive breastfeeding, mixed feeding, and exclusive formula feeding. Participants were analyzed in two groups based on their PPWR assessment at 6 and 12 months postpartum, with complete datasets available for each assessment. We calculated PPWR by subtracting pre-pregnancy weight from self-reported weight at 6 and 12 months postpartum, defining substantial PPWR as ≥5 kg retention. Modified Poisson regression models adjusted for potential confounders were performed. At 6 and 12 months, 35% (n = 132/379) and 31% (n = 109/347) of women experienced substantial PPWR, respectively. Compared to exclusive breastfeeding, mixed feeding (risk ratio 1.85; 95% confidence interval 1.15, 2.99) and exclusive formula feeding (2.11; 1.32, 3.28) were associated with a higher risk of substantial PPWR at 6 months. These associations were slightly attenuated at 12 months and appeared stronger in women with pre-pregnancy overweight or obesity. This study suggests that breastfeeding by 6 months postpartum may help mitigate PPWR, particularly with exclusive breastfeeding. It also draws attention to targeted interventions to promote breastfeeding among women with overweight or obesity. Full article

Pre-pregnancy overweight and obesity are associated with increased risk for adverse outcomes, such as gestational diabetes mellitus (GDM). This study investigated weight trajectories, eating behaviors, and metabolic consequences in women with GDM during pregnancy and postpartum according to pre-pregnancy BMI. We prospectively included 464 women with GDM. Intuitive eating (Intuitive Eating Scale-2 questionnaire), gestational weight gain (GWG), postpartum weight retention (PPWR) at 6–8 weeks and 1-year postpartum, and glucose intolerance (prediabetes and diabetes) at 1-year were assessed. Women with obesity (WOB) had lower GWG but gained more weight in the postpartum (p < 0.0001). PPWR at 1-year did not differ across BMI categories (p = 0.63), whereas postpartum weight loss was most pronounced in women with normal weight (p < 0.0001), and within this category, in their lowest tertile (p < 0.05). Intuitive eating was not linked to perinatal weight changes but differed among BMI categories. PPWR predicted a 2.5-fold increased risk of glucose intolerance at 1-year independent of pre-pregnancy BMI (p < 0.001), and the adverse metabolic impact of PPWR was most pronounced in WOB with odds of increased risk of glucose intolerance 8.9 times higher (95% CI 2.956;26.968). These findings suggest an adaptive capacity to relatively rapid weight changes in the perinatal period that is less present with higher BMI. Full article

Physiologically based pharmacokinetic (PBPK) modelling is a bottom-up approach to predict pharmacokinetics in specific populations based on population-specific and medicine-specific data. Using an illustrative approach, this review aims to highlight the challenges of incorporating physiological data to develop postpartum, lactating women and breastfed infant PBPK models. For instance, most women retain pregnancy weight during the postpartum period, especially after excessive gestational weight gain, while breastfeeding might be associated with lower postpartum weight retention and long-term weight control. Based on a structured search, an equation for human milk intake reported the maximum intake of 153 mL/kg/day in exclusively breastfed infants at 20 days, which correlates with a high risk for medicine reactions at 2–4 weeks in breastfed infants. Furthermore, the changing composition of human milk and its enzymatic activities could affect pharmacokinetics in breastfed infants. Growth in breastfed infants is slower and gastric emptying faster than in formula-fed infants, while a slower maturation of specific metabolizing enzymes in breastfed infants has been described. The currently available PBPK models for these populations lack structured systematic acquisition of population-specific data. Future directions include systematic searches to fully identify physiological data. Following data integration as mathematical equations, this holds the promise to improve postpartum, lactation and infant PBPK models. Full article

This study aimed to investigate whether the effects of an exercise program during pregnancy on postpartum body composition are moderated by following a healthy dietary pattern (i.e., Mediterranean diet (MD)). Eighty-three pregnant women (control n = 40, exercise n = 43) were included in the present quasi-experimental study. The exercise intervention consisted of a 60 min, 3 day/week throughout pregnancy from gestational week 17, supervised concurrent (aerobic + resistance) exercise program. A food frequency questionnaire and the MD Score (min–max: 0–50) were employed to assess dietary habits and the MD adherence during pregnancy, respectively. Postpartum body composition was measured with dual-energy X-ray absorptiometry, 6 weeks postpartum. The body mass index and the gynecoid fat mass at postpartum were lower in the exercise compared to the control group (p = 0.018 and p = 0.047, respectively). There was an interaction showing that the MD adherence during pregnancy positively moderated the effects of the exercise intervention on postpartum lean mass (p = 0.024), fat mass percentage (p = 0.092), android fat mass (p = 0.076), and android-to-gynecoid fat mass (p = 0.019). The Johnson–Neyman technique revealed that the effects of exercise were enhanced at a MD score of ~31 for lean mass, ~25 for fat mass, ~23 for android fat mass and ~29 for android-to-gynecoid fat mass. Our results suggest that a concurrent-exercise training plus an optimal MD adherence during pregnancy might be a useful strategy to promote a healthier body composition at the postpartum period. Full article

Per- and polyfluoroalkyl substances (PFAS), widely used in industrial and consumer products, are suspected metabolic disruptors. We examined the association between a PFAS mixture during pregnancy and postpartum weight retention in 482 participants from the New Hampshire Birth Cohort Study. PFAS concentrations, including perfluorohexane sulfonate, perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), perfluorononanoate (PFNA), and perfluorodecanoate, were quantified in maternal plasma collected at ~28 gestational weeks. Postpartum weight change was calculated as the difference between self-reported weight from a postpartum survey administered in 2020 and pre-pregnancy weight abstracted from medical records. Associations between PFAS and postpartum weight change were examined using Bayesian kernel machine regression and multivariable linear regression, adjusting for demographic, reproductive, dietary, and physical activity factors; gestational week of blood sample collection; and enrollment year. PFOS, PFOA, and PFNA were positively associated with postpartum weight retention, and associations were stronger among participants with a higher pre-pregnancy body mass index. A doubling of PFOS, PFOA, and PFNA concentrations was associated with a 1.76 kg (95%CI: 0.31, 3.22), 1.39 kg (−0.27, 3.04), and 1.04 kg (−0.19, 2.28) greater postpartum weight retention, respectively, among participants who had obesity/overweight prior to pregnancy. Prenatal PFAS exposure may be associated with increased postpartum weight retention. Full article

Individuals with body mass index (BMI) ≥ 25 kg/m² before pregnancy have greater difficulty losing the weight gained during pregnancy, and this postpartum weight retention predicts higher risk for cardiometabolic disease. The postpartum period involves substantial disruptions in circadian rhythms, including rhythms related to eating, physical activity, sleep, and light/dark exposure, each of which are linked to obesity and cardiometabolic disease in non-pregnant adult humans and animals. We posit that a multi-component, circadian timing system-based behavioral intervention that uses digital tools—ClockWork—will be feasible and acceptable to postpartum individuals and help promote weight- and cardiometabolic health-related behaviors. We provide data from stakeholder interviews with postpartum individuals (pre-pregnancy BMI ≥ 25; n = 7), which were conducted to obtain feedback on and improve the relevance and utility of digital self-monitoring tools for health behaviors and weight during the postpartum period. Participants perceived the ClockWork intervention and digital monitoring app to be helpful for management of postpartum weight-related health behaviors. They provided specific recommendations for increasing the feasibility intervention goals and improving app features for monitoring behaviors. Personalized, easily accessible interventions are needed to promote gestational weight loss after delivery; addressing circadian behaviors is an essential component of such interventions. Future studies will evaluate the efficacy of the ClockWork intervention and associated digital tools for improving cardiometabolic health-related behaviors linked to the circadian timing system during the postpartum period. Full article

Postpartum weight retention contributes to maternal obesity and varies by ethnicity. Despite the well-established benefits of lifestyle intervention on weight management, little is known about how to engage postpartum women effectively, especially among ethnic minority groups. This multi-methods study aimed to explore ethnic differences in women’s preferences for lifestyle intervention after childbirth. Women within five years of childbirth and living with their youngest child in Australia were recruited in an online survey (n = 504) and semi-structured interviews (n = 17). The survey and interview questions were structured based on the Template for Intervention Description and Replication (TIDieR) framework. Ethnic groups were categorized as Oceanian, Asian and Other according to the Australian Bureau of Statistics. Chi-square tests were used to compare the preferred intervention characteristics between groups. Qualitative data were thematically analysed. The survey showed that most women across all ethnic groups were interested in receiving lifestyle support in the early postpartum period (from 7 weeks to 3 months postpartum). All ethnic groups preferred a regular lifestyle intervention delivered by health professionals that promotes accountability and provides practical strategies. However, Asian women had a higher desire for infant care and a lower desire for mental health in the intervention content compared with Oceanian women. Moreover, Asian women were more likely to favour interventions that are initiated in a later postpartum period, over a shorter duration, and with less intervention frequency, compared with Oceanian women. The interviews further indicated the need for intervention adaptations in the Asian group to address the cultural relevance of food and postpartum practices. These ethnic-specific preferences should be considered in the development of culturally appropriate intervention strategies to optimize engagement in healthy lifestyles among the targeted ethnic groups. Full article

Excessive postpartum weight retention puts women at risk for health problems. This study aimed to investigate the effects of dairy foods on weight retention and risk of obesity in postpartum women in the Nurses’ Health Study II. Weight was reported every 2 years. We identified the pre-pregnancy and postpartum exams that were approximately 2 years before and after the birth year. Dairy consumption was averaged during these 4 years. Linear models were used to assess postpartum weight retention. Multivariable models were used to estimate risk of obesity. Women with higher yogurt (≥2 servings/week vs. <1 serving/month) intakes had 0.61 pounds less postpartum weight retention. Consuming ≥ 5 cheese servings/week was associated with 0.63 pounds less weight retention than the lowest intake. Among sedentary women, only yogurt intake was associated with lower risk of postpartum obesity (RR: 0.84; 95% CI: 0.71–1.00), though of borderline statistical significance. Among women with less healthy diets, yogurt consumption was also associated with lower postpartum obesity risk (RR: 0.70; 95% CI: 0.57–0.85). In sum, higher yogurt and cheese intakes were associated with less postpartum weight retention and among higher risk women (sedentary or lower diet quality) greater yogurt intake was associated with lower risks of postpartum obesity. Full article