Low-Income Women's Reproductive Weight Patterns: Empirically Based Clusters of Prepregnant, Gestational, and Postpartum Weights
Received 12 December 2008; received in revised form 4 May 2009; accepted 6 August 2009. published online 18 September 2009.
Background
Women have varying weight responses to pregnancy and the postpartum period. The purpose of this study was to derive sub-groups of women based on differing reproductive weight clusters; to validate clusters by reference to adequacy of gestational weight gain (GWG) and postpartum incremental weight shifts; and to examine associations between clusters and demographic, behavioral, and psychosocial variables.
Method
A cluster analysis was conducted of a multi-ethnic/racial sample of low-income women (n = 247). Clusters were derived from three weight variables: prepregnant body mass index, GWG, and postpartum retained weight.
Results
Five clusters were derived: Cluster 1, normal weight–high prenatal gain–average retain; cluster 2, normal weight–low prenatal gain–zero retain; cluster 3, high normal weight–high prenatal gain–high retain; cluster 4, obese–low prenatal gain–average retain; and cluster 5, overweight–very high prenatal gain–very high retain. Clusters differed with regard to postpartum weight shifts (p < .001), with clusters 3, 4, and 5, mostly gaining weight between 6 weeks and 12 months postpartum, whereas clusters 1 and 2 were losing weight. Clusters were also associated with race/ethnicity (p < .01), breastfeeding immediately postdelivery (p < .01), smoking at 12 months (p < .05), and reaching weight goals at 6 and 12 months (p < .001), but not depressive symptoms, fat intake habits, or physical activity.
Conclusion
In a five-cluster solution, postpartum weight shifts, ethnicity, and initial breastfeeding were among factors associated with clusters. Monitoring of weight and appropriate intervention beyond the 6 weeks after birth is needed for low-income women in high normal weight, overweight, and obese clusters.
School of Nursing, The University of Texas at Austin, Austin, Texas
Correspondence to: Lorraine O. Walker, RN, EdD, MPH, School of Nursing, The University of Texas at Austin, 1700 Red River Street, Austin, TX 78701; Phone: 512-232-4751.
Data used in this study were originally gathered with partial support from RO1 NR04679.
ABSTRACT