All ETDs from UAB

Advisory Committee Chair

Paula C Chandler-Laney

Advisory Committee Members

Brenda M Bertrand

Jose R Fernandez

Timothy R Nagy

Document Type

Thesis

Date of Award

2015

Degree Name by School

Master of Science (MS) School of Health Professions

Abstract

Objective: To examine the associations of gestational weight gain (GWG) and breastfeeding (BF) with postpartum (PP) weight change among African American women. Methods: Healthy, low-income African American women (n=32) were enrolled in a prospective observational cohort study of early life origins of obesity. GWG was calculated using data retrieved from medical records. Women were stratified according to the 2009 Institute of Medicine (IOM) GWG guidelines. Investigators measured maternal body weight at 2-weeks and 3-months PP, with the difference reflecting PP weight change. BF status at 2-weeks PP was self-reported. Analysis of covariance with Bonferroni post hoc testing was used to examine whether women with excessive GWG gained more weight PP than women who met IOM recommendations, as well as whether PP weight change differed by BF status at 2-weeks PP. Early pregnancy body mass index (BMI) was included as a covariate to adjust for body size. Multiple linear regression analysis was used to examine whether GWG group, BF, and BMI are independent predictors of PP weight change. Results: Contrary to the hypothesis, no difference in PP weight change was found among women by GWG guideline when adjusted for BMI. However, BMI was significantly associated with PP weight change (P<0.05). Women who reported any extent of BF at 2-weeks PP gained significantly more PP weight compared to those who reported no BF (P<0.05). Results of the multiple linear regression showed early pregnancy BMI remained positively associated with PP weight change (partial r=0.59, P<0.05), and BF tended to be associated with PP weight change (partial r=0.28, P=0.06). GWG was not associated with PP weight change in the multiple linear regression model. Conclusions: These findings suggest that for low-income African American women, pre-pregnancy obesity and BF may each be associated with PP weight gain. If replicated in a larger cohort, these results suggest that PP weight gain may be related more to pre-pregnancy weight status than to weight gain during pregnancy. It is suggested that future research examine behavioral, environmental, and social factors associated with BF and how these factors contribute to weight gain PP.

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