Associations of maternal material hardships during childhood and adulthood with prepregnancy weight, gestational weight gain, and postpartum weight retention

Abstract

Background: We examined associations of material hardship with prepregnancy body mass index (BMI), gestational weight gain (GWG), and substantial postpartum weight retention (SPPWR; ≥5 kg at 1 year).

Methods: We studied 2128 women in Project Viva, a Boston-area cohort with recruitment during1999-2002. At recruitment, women reported whether they experienced material hardship, defined as having ever received public assistance, welfare, or lacked basic necessities (food, rent, or medical care) during childhood, in adulthood before pregnancy, and/or in pregnancy. We used multivariable logistic models adjusted for age, race/ethnicity, and parity (and prepregnancy BMI for GWG and SPPWR) to examine associations of material hardship with the three weight-related outcomes (BMI, GWG, and SPPWR).

Results: Mean age was 31.8 (standard deviation, 5.2) years; 66% of women were white, 16% were obese (prepregnancy BMI ≥30.0 kg/m(2)), 50% experienced excessive GWG, and 17% experienced SPPWR. Material hardship was most common during childhood (n=192, 9%), followed by adulthood (102, 5%), and pregnancy (41, 2%). Hardship in adulthood was associated with prepregnancy obesity (BMI ≥30 kg/m(2) vs. 18.5 to <25.0 kg/m(2)), odds ratio ([OR] 2.35, 95% confidence interval [CI] 1.29, 4.31), but hardship in childhood was not (OR 1.26, 95% CI 0.80, 1.98). Hardship in childhood was associated with excess GWG (OR 1.45, 95% CI 0.99, 2.14), but hardship in adulthood or during pregnancy was not. We saw trends among hardship in each of the periods and associations with SPPWR, but all confidence intervals included the null.

Conclusion: The timing of hardship exposure may differently influence weight before, during, and after pregnancy.

FIG. 1.

Odds of prepregnancy obesity, excessive gestational weight gain, and substantial postpartum weight retention according to the timing of material hardship exposure among women in the Project Viva cohort. The reference group for each analysis is women who never experienced material hardship. Error bars are 95% confidence intervals around the odds ratio. GWG, gestational weight gain; PPWR, postpartum weight retention.