Late postpartum weight retention carries adverse metabolic consequences

Women who gain weight during pregnancy and retain it long after delivery are likely to have elevated fasting glucose and HbA1c levels, on top of having higher body mass index (BMI) and weight, as reported in a recent study.

Researchers prospectively examined postpartum weight retention (PPWR) at 6–8 weeks in 862 women (mean maternal age, 33.0 years; mean gestational age at delivery, 38.4 weeks). Of the women, 259 had PPWR data at 1 year. Overall, 44 percent of the women were nulliparous. Half of the population had a family history of diabetes, whereas only 6 percent had a previous history of gestational diabetes mellitus (GDM).

The mean pre-pregnancy BMI was 25.6 kg/m², with 52.6 percent, 27.5 percent, and 19.9 percent of women having initial normal weight, overweight, or were obese prior to pregnancy, respectively. Total gestational weight gain (GWG) was 12.7 kg.

Mean PPWR was 4.6 kg at 6–8 weeks and 4.0 kg at 1-year. The proportion of women with PPWR at the said time points were 81 percent and 66.4 percent, respectively.

Women with vs without PPWR at 6–8 weeks postpartum had higher pre-pregnancy weight, higher GWG, and higher postpartum weight, without presenting metabolic differences. At 1-year postpartum, anthropometric parameters before and during pregnancy did not significantly differ between the two groups, except those with PPWR who had 4-kg higher GWG (p<0.001).

Generally, women with PPWR had increased postpartum weight and BMI, higher fasting glucose, and more pronounced increases in fasting glucose and HbA1c at 1-year (p≤0.03). GWG predicted higher PPWR at both 6–8 weeks and at 1-year postpartum (p<0.001).

In light of the findings, the researchers underscored a need for a continuous follow-up of women with GDM, focusing specifically on weight and glucose control.