Association of pre-pregnancy BMI and gestational weight gain with fat mass distribution and accretion during pregnancy and early postpartum: a prospective study of Albertan women
Mary Barker,
Nicole Letourneau,
Catherine J Field,
Fatheema B Subhan,
Lisa Shulman,
Linda J McCargar,
Linglong Kong,
Rhonda C Bell,
Bonnie J Kaplan,
Deborah Dewey,
Francois Bernier,
Marja Cantell,
Linda Casey,
Misha Eliasziw,
Anna Farmer,
Lisa Gagnon,
Gerry Giesbrecht,
Laki Goonewardene,
Libbe Kooistra,
Donna Mance,
Jon Martin,
Linda Mccargar,
Maeve O’brien,
Victor Pop,
Nalini Singhal,
Brenda Leung,
Rhonda Bell,
Paula Robson,
Maria Mayan,
Terri Miller,
Ellen Toth,
Richard Oster,
Kim Raine,
Dolly Bondarianzadeh,
Iiona Csizmadi,
Venu Jain,
Kara Narenberg,
Carla Prado,
Arya Sharma,
Sheile Tyminski,
Kristi Adamo,
Elizabeth Adams,
Michelle Berlin,
Sally Bowman,
Hilde Brekke,
Wemdy Lawrence,
Christine Olson,
Sara Wilson-Wolfe,
Sue Woodbury
Affiliations
Mary Barker
MRC Lifecourse Epidemiology Centre, University of Southampton, Faculty of Medicine, Southampton, UK
Nicole Letourneau
8 Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
Catherine J Field
3 Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
Fatheema B Subhan
1 Department of AFNS, University of Alberta, Edmonton, Alberta, Canada
Lisa Shulman
2 Department of Mathematical & Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada
Linda J McCargar
1 Department of AFNS, University of Alberta, Edmonton, Alberta, Canada
Linglong Kong
2 Department of Mathematical & Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada
Rhonda C Bell
Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada
Bonnie J Kaplan
Deborah Dewey
Owerko Centre at the Alberta Children`s Hospital Research Institute and Departments of Pediatrics and Community Health Sciences, The University of Calgary, Calgary, Alberta, Canada
Francois Bernier
Department of Medical Genetics, Alberta Children`s Hospital, Calgary, Alberta, Canada
Marja Cantell
Linda Casey
Misha Eliasziw
Anna Farmer
Lisa Gagnon
Gerry Giesbrecht
Laki Goonewardene
Libbe Kooistra
Donna Mance
Jon Martin
Linda Mccargar
Maeve O’brien
Victor Pop
Department of Medical Health Psychology, Tilburg University, Tilburg, The Netherlands
Nalini Singhal
Pediatrics, University of Calgary, Calgary, Alberta, Canada
Brenda Leung
University of Lethbridge, Lethbridge, Alberta, Canada
Rhonda Bell
Paula Robson
Maria Mayan
Terri Miller
Ellen Toth
Richard Oster
Department of Agricultural, Food & Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada
Kim Raine
Dolly Bondarianzadeh
Iiona Csizmadi
Venu Jain
Kara Narenberg
Carla Prado
Arya Sharma
Sheile Tyminski
Kristi Adamo
Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
Elizabeth Adams
1 Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, North Carolina, USA
Objectives To examine the patterns of fat mass gain in pregnancy and fat loss in the early postpartum period relative to women’s pre-pregnancy body mass index (BMI) and by adherence to Institute of Medicine’s gestational weight gain (GWG) recommendations.Design Prospective cohort study with three to four study visits.Setting This study is a part of the prospective longitudinal birth cohort, ‘The Alberta Pregnancy Outcomes and Nutrition Study’ (APrON) that recruited pregnant women from the cities of Edmonton and Calgary in Alberta.Participants 1820 pregnant women were recruited and followed through their pregnancy and at 3 months postpartum.Outcome measures Body weight and skinfold thicknesses were measured during pregnancy and early postpartum in women. Body density was calculated from sum of skinfold thickness (biceps, triceps, subscapula and suprailiac), and total fat mass accretion during pregnancy was calculated using Van Raaij’s equations and at postpartum using Siri’s equation. Differences in total fat mass gain, fat mass loss and fat retention according to pre-pregnancy BMI categories and GWG categories were tested using two-way analysis of variance and post hoc comparisons.Results Most women (64%) had a normal pre-pregnancy BMI, and overall 49% women exceeded the GWG recommendations. Obese women gained significantly less total fat mass, had lower fat mass loss and had lower postpartum fat retention than normal-weight women (p<0.05). Women with excessive GWG gained higher total fat mass and had higher postpartum fat mass retention (p<0.03) than women who met the GWG recommendations. Total GWG was positively correlated with total fat gain (r=0.61, p<0.01) and total fat retention (r=0.31, p<0.05).Conclusion Excessive GWG is the significant risk factor for higher fat mass accretion during pregnancy and higher postpartum fat retention, irrespective of pre-pregnancy BMI.
