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Excessive Gestational Weight Gain and Subsequent Maternal Obesity at Age 40: A Hypothetical Intervention
Barbara Abrams1, Jeremy Coyle1, Alison K Cohen1
1Barbara Abrams, Alison K. Cohen, and Irene Headen are with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Jeremy Coyle and Alan Hubbard are with the Division of Biostatistics, School of Public Health, University of California, Berkeley. Lorrene Ritchie is with the Nutrition Policy Institute, Agriculture and Natural Resources, University of California, Oakland. David H. Rehkopf is with the Division of General Medical Disciplines, Stanford University School of Medicine, Palo Alto, CA.
Objectives:
To model the hypothetical impact of preventing excessive gestational weight gain on midlife obesity and compare the estimated reduction with the US Healthy People 2020 goal of a 10% reduction of obesity prevalence in adults.
Methods:
We analyzed 3917 women with 1 to 3 pregnancies in the prospective US National Longitudinal Survey of Youth, from 1979 to 2012. We compared the estimated obesity prevalence between 2 scenarios: gestational weight gain as reported and under the scenario of a hypothetical intervention that all women with excessive gestational weight gain instead gained as recommended by the Institute of Medicine (2009).
Results:
A hypothetical intervention was associated with a significantly reduced estimated prevalence of obesity for first (3.3 percentage points; 95% confidence interval [CI] = 1.0, 5.6) and second (3.0 percentage points; 95% CI = 0.7, 5.2) births, and twice as high in Black as in White mothers, but not significant in Hispanics. The population attributable fraction was 10.7% (95% CI = 3.3%, 18.1%) in first and 9.3% (95% CI = 2.2%, 16.5%) in second births.
Conclusions:
Development of effective weight-management interventions for childbearing women could lead to meaningful reductions in long-term obesity.
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