Postpartum Weight Loss in Women with Class-III Obesity: Do They Lose What They Gain?

Excessive gestational weight gain (GWG) increases risk of postpartum weight retention in normal and overweight women but little is known about weight retention in morbidly obese women. We evaluated the impact of GWG on postpartum weight retention in women with class-III obesity.

This is a retrospective cohort of pregnancies at a single institution from July 2013 to December 2017 complicated by body mass index (BMI) ≥ 40 at entry to care. Women were classified as GWG within (WITHIN), less than (LESS), or greater than (MORE) Institute of Medicine's (IOM) recommendations. Women were excluded for multiples, late prenatal care, preterm birth, fetal anomalies, intrauterine demise, weight loss, and missing data. Primary outcome was achievement of intake weight at the postpartum visit. Logistic regression was used to adjust for confounding factors.

Among 338 women, 93 (28%) gained WITHIN, 129 (38%) LESS, and 144 (43%) MORE. Women in the MORE group were less likely to achieve their intake weight at the postpartum visit (adjusted odds ratio [AOR] = 0.09 95% confidence interval [CI]: 0.05-0.17, p < 0.01). Women gaining MORE were the only group who did not lose weight from intake to postpartum (Median weight change [LESS: -14 lbs (IQR: -20 to -7)] vs. [WITHIN: -7 lbs (IQR: -13 to -1)] vs. [MORE: 5 lbs (IQR: 0-15)]; p < 0.01).

Excessive GWG in women with class-III obesity is associated with postpartum weight retention.