Trajectory of Weight Changes in the First 6 Weeks Postpartum

To determine the trajectory of postpartum weight changes and to examine associations between weight change in the first 6 weeks postpartum and demographic, clinical, psychosocial, and behavioral variables. Prospective, longitudinal design. Community hospital and university research setting. 26 low‐income women (9 White, 8 Black, and 9 Hispanic) with uncomplicated term pregnancies. Body mass index measured weekly. Among White women, body mass index decreased significantly for the first 3 weeks of the postpartum period. Black women experienced a significant reduction in body mass index for only the first 2 postpartum weeks. Similarly, the postpartum body mass index decreased for the first 2 weeks for Hispanic women. Prepregnancy body mass index and gestational weight gain each had a significant positive effect on postpartum body mass index. Perception of social support at 4 weeks had a significant positive effect on postpartum body mass index in Black women. The trajectory of weight change was nonlinear with large initial weight losses during the first 2 to 3 weeks postpartum followed by weight plateaus for the remainder of the first 6 weeks postpartum

Weight and Behavioral and Psychosocial Factors Among Ethnically Diverse, Low-Income Women After Childbirth: II. Trends and Correlates

Objective: This paper presents a longitudinal analysis of behavioral and psychosocial correlates of weight trends during the first postpartum year. Data are derived from the Austin New Mothers Study (ANMS), a longitudinal study of a low-income, tri-ethnic sample of postpartum women that incorporated serial assessment of weight and behavioral and psychosocial variables. Method: Postpartum body mass index (BMI) was measured prospectively (post-delivery, 6 weeks, and 3, 6, and 12 months postpartum). The analytic sample consisted of 382 White, African American, and Hispanic women receiving maternity care funded by Medicaid who had at least three measured postpartum weights. Behavioral and psychosocial variables included energy intakes, fat intakes, physical activity, health-related lifestyle, smoking, breastfeeding, contraception, depressive symptoms, emotional eating, body image, and weight-related distress. Results: Using hierarchical linear modeling to incorporate baseline only and time-varying effects, significant associations with postpartum BMI were found for the following variables: ethnicity (p = .001), time of weight measurement (p < .001), the interaction of ethnicity and time (p = .005), prepregnant BMI (p < .001), gestational weight gain (p < .001), weight-related distress (p < .001), and energy intakes (p = .005). After adjusting for covariates, ethnic groups displayed differing trends in postpartum BMI resulting in White women having significantly lower BMIs at 12 months postpartum compared to ethnic minority women (p's < .01). Conclusion: Behavioral and psychosocial variables contribute to a fuller understanding of BMI status of low-income women during the first postpartum year

Weight and Behavioral and Psychosocial Factors Among Ethnically Diverse, Low-Income Women After Childbirth: I. Methods and Context

Objective: In this paper, we present the background, hypotheses, methods, and descriptive findings from the Austin New Mothers Study, a longitudinal series measuring weight and contextual variables across the first postpartum year. Among the distinguishing features of this study are its tri-ethnic sample of low-income women and its serial measurement of the behavioral and psychosocial context of postpartum weight changes post-delivery and at 6 weeks, and 3, 6, and 12 months postpartum. Method: A prospective longitudinal design was used to assess body mass index (BMI), energy intake, fat intake, physical activity, health-related lifestyle, depressive symptoms, body image, and weight-related distress at each observation. Sample: The analytic sample consisted of 382 White, African American, and Hispanic women. Findings: For BMI, effects for ethnicity (p < .001), time (p < .001), and their interaction (p = .005) were significant. All ethnic groups had significant declines in BMI from delivery to 6 weeks postpartum. Thereafter, BMIs of White women declined during the second 6 months, whereas those of Hispanic and African American women either displayed small gains or plateaus between adjacent observations. Time-related effects were significant for behavioral and psychosocial variables except for body image and weight-related distress, whereas effects for ethnicity were significant on fat intake, depressive symptoms, and body image. Despite declines in depressive symptoms, women remained at risk of depression across the first postpartum year. Conclusions: Low-income ethnic minority women have a higher vulnerability to postpartum weight gains or plateaus. High depressive symptoms occurred in all ethnic groups examined