ethnic differences in weight retention after pregnancy in hawai`i
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Ethnic Differences in Weight Retention After Pregnancy in Hawai`i. G. Baruffi, C. Hardy, C. Waslien, S. Uyehara, D. Krupitsky. Introduction. Obesity in the U.S. has become an epidemic Obesity rates have increased by nearly 60% since 1991, and by 6% between 1998 and 1999 (CDC) - PowerPoint PPT PresentationTRANSCRIPT
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Ethnic Differences in Weight Retention After Pregnancy in Hawai`i
G. Baruffi, C. Hardy, C. Waslien, S. Uyehara, D.
Krupitsky
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Introduction Obesity in the U.S. has become
an epidemic Obesity rates have increased by
nearly 60% since 1991, and by 6% between 1998 and 1999 (CDC)
50% of women 25-55 yrs of age are either overweight or obese
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Introduction (cont) Adequate weight gain during
pregnancy is important for optimal pregnancy outcomes
Excessive weight gain during pregnancy and retention of weight 6 months after delivery are predictors of long-term obesity
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Introduction (cont) Weight gain during pregnancy
and weight retention postpartum vary by: Prepregnancy BMI Parity, Age Breastfeeding, Smoking, Exercise Race/ethnicity
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Purpose of the study Reported racial differences are
between Black and White women
Purpose of this study: to investigate weight gain during pregnancy and weight retention postpartum in a multiethnic population of women in Hawai`i
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Methods Cross sectional study of
postpartum women attending the Hawai`i WIC Program in 1997-98
Weight gain during pregnancy self reported
Weight and height at postpartum visit measured by WIC staff
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Methods (cont) Ethnicity self reported Seven ethnic groups:
Asian (Japanese, Chinese, Korean) Black Caucasian (White, Puerto Rican, Spanish) Filipino Hawaiian (Hawaiian, Part-Hawaiian) Samoan Other
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Analysis First postpartum visit
5,863 women
Bivariate and multivariate analysis
SAS
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Distribution of postpartum women by ethnicity. Hawai`i WIC 1997-98 Ethnicity N %Asian BlackCaucasianFilipinoHawaiianSamoanOtherTOTAL
405 (6.9) 254 (4.3) 1593 (27.2) 1162 (19.8) 1751 (29.9) 236 (4.0) 456 (7.8) 5,863 (100)
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Distribution of women by post partum duration and ethnicity. Hawai`i WIC 1997-98Ethnicity Postpartum duration
(months)% <1 % 1-2 % 3-4 % 5-6 % >6
AsianBlackCaucasianFilipinoHawaiianSamoanOther
21252021192624
42474047484441
19151819211919
5685434
1481488812
Total % 21 45 19 5 10
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IOM recommendations for WT gain by prepregnancy BMI BMI Weight gain
(lbs)< 19.8 28 – 4019.8 – 26 25 – 3526.1 – 29.0 15 – 25> 29.0 15
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Distribution of women by prepregnancy BMI and WT gain. Hawai`i WIC 1997-98 BMI %
WomenWT gain (lbs)
<19.8 17.4 33.7 +12.7
19.8–26 51.7 34.6 +15.2
26.1–29.0
10.8 32.0 +16.6
>29.0 20.1 27.2 +20.0
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Prepregnancy BMI and pregnancy weight gain by ethnicity. Hawai`i WIC 1997-98Ethnicity BMI
Mean SDWeight gain(lbs)Mean SD
AsianBlackCaucasianFilipinoHawaiianSamoanOther
22.7 +5.3 25.2 +5.0 24.5 +5.4 22.5 +4.4 26.1 +6.3 29.7 +6.9 24.6 +6.1
29.1 +12.9 32.1 +16.4 33.4 +15.9 30.0 +13.3 34.1 +17.7 37.3 +22.0 32.9 +16.7
Overall ethnic differences in prepregnancy BMI: p-value <.0001Overall ethnic differences in mean weight gain: p-value <.0001
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Postpartum weight loss and retention by postpartum duration. Hawai`i WIC 1997-98 PP months
WT loss (lbs) Mean SD
WT retention (lbs) Mean SD
< 1 1 - 2 3 - 4 5 - 6 7 - 8 > 8
18.7 +11.1
20.8 +10.7
21.1 +11.9
23.4 +13.6
23.8 +15.3
23.7 +14.3
14.8 +15.7
11.8 +13.4
11.5 +14.1
9.4 +13.5
8.7 +16.0
7.4 +15.0
Overall difference in weight loss: p-value <.0001Overall difference in weight retention: p-value <.0001
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Postpartum weight loss and retention by ethnicity. Hawai`i WIC 1997-98 Ethnicity
WT loss (lbs)Mean SD
WT ret (lbs) Mean SD
AsianBlackCaucasianFilipinoHawaiianSamoanOther
19.5 +9.620.4 +12.122.2 +11.619.1 +9.221.8 +12.619.8 +16.019.5 +13.4
9.6 +11.211.7 +14.111.1 +13.511.0 +11.312.3 +15.717.5 +21.713.3 +16.3
Overall differences in WT loss: p-value <. 0001Overall differences in WT retention: p-value <.0001
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Multiple regression of WT retention by ethnicity. Hawai`i WIC 1997-98Ethnicity Β coefficient p-
valueAsianBlackFilipinoHawaiianSamoanOther
1.095 0.0494 0.958 0.1559 1.606 <.0001 0.363 0.2951 3.469 <.0001 2.308 <.0001
NOTE: Reference category = Caucasian. Weight retention is adjusted for weight gain during pregnancy, postpartum days, and age.
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Conclusions 30% of women were overweight or
obese before pregnancy
Overweight and obese women had an excessive weight gain during pregnancy
Average weight retention at 5-6 months pp was 9.4 lbs, and 7.4 lbs after 8 months pp
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Conclusions (cont) Overall significant ethnic
differences in prepregnancy BMI
Samoan had the highest mean prepregnancy BMI (29.7)
Filipino had the lowest mean prepregnancy BMI (22.5)
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Conclusions (cont) Overall significant ethnic
differences in weight gain during pregnancy
Samoans had the highest mean weight gain (37.3 lbs)
Asian had the lowest mean weight gain (29.1 lbs)
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Conclusions (cont) Overall significant ethnic
differences in weight retention
Samoan had the largest average wt retention (17.5 lbs)
Asian had the smallest average wt retention (9.6 lbs)
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Conclusions (cont) Adjusting for weight gain during
pregnancy, pp duration, and age, all ethnicities, except Black and Hawaiian, retained significantly more weight than Caucasian.
Samoan retained the most (3.5 lbs) Asian retained the least (1.1 lbs)
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Recommendations For each lb of weight gained
during pregnancy there was almost 2/3 lb adjusted weight retention
Importance of controlling weight gain during pregnancy
Importance of loosing weight after delivery