Postnatal research offers clues to tackling maternal obesity

A study has been conducted at Newcastle University, United Kingdom (UK), to assess postnatal dietary patterns, physical activity status, and changes in body weight among obese women living in a highly deprived region in the UK.

The study is published in the Nutrients Journal.

Study: Maternal Obesity and Patterns in Postnatal Diet, Physical Activity and Weight among a Highly Deprived Population in the UK: The GLOWING Pilot Trial. Image Credit: Studio Romantic/Shutterstock.com

Background

Pre-pregnancy obesity is associated with adverse pregnancy and post-pregnancy outcomes, including preeclampsia, gestational diabetes, cesarean deliveries, stillbirth, fetal developmental disorders, and maternal and fetal mortality. In the UK, one in five pregnant women are obese and, thus, experience many health adversities.

Weight gain during pregnancy (gestational weight gain) is a natural process to provide sufficient space for the growing fetus. However, more than 50% of women exceed the recommended limit of gestational weight gain, and the prevalence is highest among women with pre-pregnancy obesity.

Thus, pre-pregnancy weight management through dietary and physical activity interventions is necessary for better pregnancy outcomes.

In this study, scientists have surveyed postnatal dietary and physical activity patterns and weight change in obese women living in a highly deprived region in the UK.

Study design

The data collected from the GLOWING pilot trial was analyzed in this study. The GLOWING pilot trial was conducted to support midwives’ implementation of UK guidelines for weight management during pregnancy.

The study population included 39 obese women who completed food frequency and physical activity questionnaires and provided weight measurements at 3-, 6-, 9-, and 12-month postnatal time points.

Important observations

Dietary pattern

The analysis of dietary patterns revealed that, on average, the participants consumed 142 mL of milk, 5-10 gm of spread, and 4-12gm cheese per day.

The intake of sugary drinks, especially sugar-sweetened beverages, was the highest at three months postnatal. The intake of carbohydrates was low at all postnatal time points.

The intake of fruits and vegetables and unprocessed fish (oily fish) was lower than the UK recommendations. Red meat and processed meat were the participants’ primary sources of meat intake.

Physical activity

The analysis of physical activity patterns revealed a gradual increase in energy expenditure during the postnatal study period, ranging from 213.4 metabolic energy equivalent (MET)-hour per week at three months postnatal to 300.7 MET-hour per week at 12 months postnatal.

Most energy expenditure was from light-intensity physical activities, followed by moderate-intensity activities.

Vigorous physical activity was observed for only a very few cases. Regarding the types of physical activities, most energy expenditure was achieved from household or care activities. The lowest level of energy expenditure was achieved from occupational and sports activities.

Weight change

The weight change analysis revealed weight loss across postnatal time points compared to the first and third trimesters. The lowest weight was observed at three months, gradually increasing over time and reaching the highest value at 12 months postnatal.

Across postnatal time points, the average weight loss from the first trimester was higher among participants without excessive gestational weight gain than those with excessive weight gain. However, no significant difference in weight loss from the third trimester was observed between participants with and without excessive gestational weight gain.

Study significance

The study finds inadequacy in postnatal dietary intake and physical activity among women with obesity who live in a highly deprived region in the UK. In particular, fruits, vegetables, and oily fish intake is well below the recommended UK guidelines for weight management in the postnatal period.

Notably, the study finds a promising pattern of postnatal weight loss, which suggests that avoiding excessive weight gain during pregnancy can be beneficial for achieving higher weight loss in the early postnatal period.

This strategy might be helpful for women to achieve a postnatal body weight lower than their first-trimester body weight. Proper postnatal weight management before subsequent pregnancies would result in healthy maternal and fetal outcomes.  

Given these observations, scientists highlight the need for more longitudinal studies involving a larger population of deprived women with obesity to develop pre-pregnancy weight management strategies for better pregnancy outcomes.