Predictors of postpartum weight retention: A hospital-based longitudinal observational study in India

Postpartum weight retention (PPWR) is a critical public health concern linked to long-term obesity and metabolic disorders. This study aimed to identify predictors of PPWR at 6-months among overweight and obese postpartum women in India.

A longitudinal observational study was conducted on 210 postpartum women at a tertiary care hospital. PPWR was defined as the difference of ≥ 5.0 kg between pre-pregnancy and 6-months postpartum. Predictor variables included socio-demographic, obstetric, anthropometric, and lifestyle-related factors. Multiple logistic regression was employed to determine associations.

The mean age of participants was 29.4 ± 4.1 years, and mean PPWR was 6.0 ± 4.3 kg. Overall, 55.2 % retained > 5.0 kg at 6-months postpartum. Significant predictors included socioeconomic status (Upper/Upper middle class: AOR 2.784; Lower middle: AOR 4.077), gestational weight gain (AOR 3.667), pre-pregnancy BMI (AOR 0.599), and BMI at 3-months (Obese I: AOR 6.746; Obese II: AOR 67.128). Among dietary factors, inadequate energy intake at 3-months (AOR 2.600), high energy from carbohydrates (AOR 3.317) and fats (AOR 12.463) at 3-months and decline in protein energy contribution from baseline to endline (AOR 1.293) were associated with increased risk. A reduction in visible fat intake during the study period showed a protective effect (AOR 0.938).

PPWR is influenced by socioeconomic, anthropometric, and dietary factors. Regular screening, gestational weight monitoring, and balanced macronutrient intake in the early postpartum phase may help mitigate PPWR risk.