The association between neighborhood walkability and postpartum weight retention: A prospective cohort study

Postpartum weight retention is common and contributes to overweight and obesity. Living in a more walkable neighborhood may influence postpartum weight retention by encouraging physical activity and overall weight management. This study explores the potential association between neighborhood walkability and postpartum weight retention.

The P3 Cohort is a prospective pregnancy cohort study. Participants were recruited at <32 weeks gestation and followed until 12 months postpartum.

The proportion of postpartum weight retention was calculated by dividing the difference between self-reported weight at 6 and 12 months postpartum by pre-pregnancy weight. Participants' addresses at the time of delivery were used to obtain neighborhood Walk Scores (a measure of neighborhood walkability). The association of the mean proportion of weight retained and Walk Score was examined using linear regression with adjustment for relevant confounding factors.

Of 1,186 cohort participants, 72.1% and 70.5% retained some of their pregnancy-related weight gain at 6 and 12 months postpartum, with a median retention of 4.5 kg and 3.0 kg, respectively. Retention varied significantly by pre-pregnancy BMI (p < 0.001), with overweight and obese participants having lower relative risks of postpartum weight retention. Walk Score was inversely associated with pre-pregnancy BMI (p = 0.011), but no significant association was found between Walk Score and postpartum weight retention at 6 or 12 months postpartum.

While Walk Score was inversely associated with pre-pregnancy BMI, no association between neighborhood walkability and postpartum weight retention was observed. Postpartum weight outcomes may be more strongly influenced by health behaviors and environmental influences.