Participants' data

Participants' dat

Accuracy of the PPAQ.

*<p>Including only women who were still working in the past trimester.</p

Physical activity levels as self-reported by the PPAQ.

*<p><i>P</i><0.05.</p

Mean (SD) GT1M values across tertiles of total energy expenditure based on the PPAQ.

*<p>Jonckheere-Terpstra.</p

Physical activity distribution during pregnancy from Actigraph’s GT1M recording.

<p>Physical activity distribution during pregnancy from Actigraph’s GT1M recording.</p

Breastfeeding Initiation: Impact of Obesity in a Large Canadian Perinatal Cohort Study

<div><p>Objective</p><p>To evaluate incidence of breastfeeding initiation according to maternal pre-pregnancy body mass index (BMI) in “Grossesse en Santé”, a large prospective birth cohort in Quebec City.</p><p>Methods</p><p>Breastfeeding initiation in the post-partum period, pre-pregnancy BMI, sociodemographic determinants and obstetrical and neonatal factors were collected from years 2005 to 2010 in 6592 women with single pregnancies. Prenatal non-intention to breastfeed was documented in a subgroup of the cohort (years 2009–2010). Log-binomial regression analyses were performed to assess relative risk (RR) of non-initiation of breastfeeding between maternal BMI categories in models including pre- and post-natal determinants, after exclusion of variables with a mediating effect.</p><p>Results</p><p>Twenty percent (20%) of obese women did not initiate breastfeeding in the post-natal period at hospital compared to 12% for normal weight women. Compared with those having a normal pre-pregnancy BMI, obese women had a higher risk of non-initiation of breastfeeding (RRunadj 1.69, 95% CI 1.44–1.98), even after adjustment for prenatal and sociodemographic factors (RRadj 1.26, 95% CI 1.08–1.46). Furthermore, the risk of non-initiation of breastfeeding in obese women still remained higher after introduction of per- and post-natal factors (RR 1.22, 95% CI 1.04–1.42). The prenatal non-intention to breastfeed was strongly associated with the non-initiation of breastfeeding for all categories of BMI.</p><p>Conclusion</p><p>Maternal obesity is associated with a two-fold rate of non-initiation of breastfeeding. Considering the benefits of breastfeeding and the increasing obesity rate, adapted interventions and specialized support should target both pre- and immediate post-natal periods in this population.</p></div

Newborn’s characteristics according to maternal pre-pregnancy body mass index.

<p>Note: BMI = Body mass index; SD = Standard deviation; SGA = Small of gestational age; APA = appropriate for gestational age; LGA = Large for gestational age</p><p>*Unless stated otherwise</p><p>^†<i>p</i> value indicates statistical difference between each BMI category and the reference category for the related characteristic</p><p>^a One value is missing</p><p>Newborn’s characteristics according to maternal pre-pregnancy body mass index.</p

Antenatal characteristics according to pre-pregnancy body mass index.

<p>Note: BMI = Body mass index; SD = Standard deviation</p><p>* Unless stated otherwise</p><p>^†<i>p</i> value indicates statistical difference between each BMI category and reference category for the related characteristic</p><p>^a At the beginning of actual pregnancy</p><p>^b During actual pregnancy</p><p>^c Refers to a previous history of illness or surgery to breast</p><p>^d Number of months of breastfeeding experimented by women with one or more previous children. Refer exclusively to multiparous women (n = 3451)</p><p>Antenatal characteristics according to pre-pregnancy body mass index.</p

Relative risk of non-initiation of breastfeeding associated with maternal pre pregnancy BMI.

<p>Note: BMI = Body mass index; CI = confidence interval; RR = Relative risk; Ref = Reference group</p><p>^a except for place and year of delivery</p><p>^b Includes age at delivery, ethnic group, marital status, education, household income, smoking status, major or minor breast history, parity, alcohol consumption during pregnancy, any history of drug use and previous breastfeeding experience</p><p>^c Includes gestational hypertension or HELLP or pre-eclampsia and gestational age at delivery</p><p>^d Includes newborn’ sex, weight, weight percentile, and apgar at 5 minutes</p><p>Relative risk of non-initiation of breastfeeding associated with maternal pre pregnancy BMI.</p

Physical activity levels throughout the study.

<p>MVPA = moderate and vigorous physical activity; PA = physical activity</p><p>^asignificant group effect, p = 0.014; values significantly higher in the exercise vs control group at all time</p><p>^bsignificant time effect, p = 0.028; values significantly lower at time 3 compared with time 2 in both groups (adjusted p = 0.027)</p><p>^csignificant time effect, p = 0.012; values significantly lower at time 3 compared with time 1 in both groups (adjusted p = 0.012)</p><p>^dsignificant time effect, p = 0.007; values significantly lower at time 3 vs time 1 and time 2 in both groups (adjusted p = 0.001 and p = 0.010).</p><p>Physical activity levels throughout the study.</p