Maternal Weight after Childbirth versus Aging-Related Weight Changes

Published:January 14, 2017DOI:



      Pregnancy weight gain is believed to contribute to female overweight and obesity. However, most studies do not account for the changes in body weight expected to occur as women age. We examined the long-term weight trajectory of childbearing women relative to weight progression that could be expected in the absence of pregnancy.


      From the hospital records of 32,187 women with two births in Wisconsin during 2006 to 2013, we extracted the maternal weight at pregravid, delivery, and subsequent pregravid. We predicted the corresponding aging-progressed weights using a weight-for-age equation adjusted for sociodemographic variables. Nonparametric mixed effects models estimated the average maternal weight trajectory and the corresponding aging-related progression through 5 years after birth.


      The estimated aging-related progression predicted a gradual annual weight increase of 1.94 pounds (95% confidence interval 1.90–1.98), from 152.79 pounds at pregravid to 163.76 pounds by 5 years after birth. Actual maternal weight followed a sinusoidal pattern: increasing during gestation, decreasing during the first postbirth year, converging with the aging-related progression during the second postbirth year, and then increasing at 2.89 pounds (95% confidence interval 2.23–3.55) annually and diverging upward from the aging-related progression to 168.03 pounds by 5 years after birth.


      Pregnancy weight gain did not contribute to the aging-related trend, but lifestyle changes of parenthood may later exacerbate the long-term trend.
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        • Ball S.J.
        • Pereira G.
        • Jacoby P.
        • de Klerk N.
        • Stanley F.J.
        Re-evaluation of link between interpregnancy interval and adverse birth outcomes: Retrospective cohort study matching two intervals per mother.
        BMJ. 2014; 349: g4333
        • Berge J.M.
        • Larson N.
        • Bauer K.W.
        • Neumark-Sztainer D.
        Are parents of young children practicing healthy nutrition and physical activity behaviors?.
        Pediatrics. 2011; 127: 881-887
        • Bogaerts A.
        • Van den Bergh B.R.
        • Ameye L.
        • Witters I.
        • Martens E.
        • Timmerman D.
        • Devlieger R.
        Interpregnancy weight change and risk for adverse perinatal outcome.
        Obstetrics & Gynecology. 2013; 122: 999-1009
        • Centers for Disease Control and Prevention
        Body mass index (BMI).
        2016 (Available:) (Accessed: April 12, 2016)
        • Choi J.
        • Fukuoka Y.
        • Lee J.H.
        The effects of physical activity and physical activity plus diet interventions on body weight in overweight or obese women who are pregnant or in postpartum: A systematic review and meta-analysis of randomized controlled trials.
        Preventive Medicine. 2013; 56: 351-364
        • Conde-Agudelo A.
        • Rosas-Bermudez A.
        • Kafury-Goeta A.C.
        Birth spacing and risk of adverse perinatal outcomes: A meta-analysis.
        JAMA. 2006; 295: 1809-1823
        • Crawford L.
        • Senyak S.
        The new-mom body survey: 7,000 women tell it like it is.
        2016 (Available:) (Accessed: April 12, 2016)
      1. Definition of term pregnancy. Committee Opinion No. 579. American College of Obstetricians and Gynecologists.
        Obstetrics & Gynecology. 2013; 122: 1139-1140
        • Endres L.K.
        • Straub H.
        • McKinney C.
        • Plunkett B.
        • Minkovitz C.S.
        • Schetter C.D.
        • Shalowitz M.U.
        Postpartum weight retention risk factors and relationship to obesity at 1 year.
        Obstetrics & Gynecology. 2015; 125: 144-152
        • Field A.E.
        • Austin S.B.
        • Taylor C.B.
        • Malspeis S.
        • Rosner B.
        • Rockett H.R.
        • Colditz G.A.
        Relation between dieting and weight change among preadolescents and adolescents.
        Pediatrics. 2003; 112: 900-906
        • Gore S.A.
        • Brown D.M.
        • West D.S.
        The role of postpartum weight retention in obesity among women: A review of the evidence.
        Annals of Behavioral Medicine. 2003; 26: 149-159
        • Gunderson E.P.
        Childbearing and obesity in women: Weight before, during, and after pregnancy.
        Obstetrics & Gynecology Clinics of North America. 2009; 36 (ix): 317-332
        • Gunderson E.P.
        • Abrams B.
        Epidemiology of gestational weight gain and body weight changes after pregnancy.
        Epidemiologic Reviews. 2000; 22: 261-274
        • Gunderson E.P.
        • Murtaugh M.A.
        • Lewis C.E.
        • Quesenberry C.P.
        • West D.S.
        • Sidney S.
        Excess gains in weight and waist circumference associated with childbearing: The Coronary Artery Risk Development in Young Adults Study (CARDIA).
        International Journal of Obesity and Related Metabolic Disorders. 2004; 28: 525-535
        • Harris K.M.
        The National Longitudinal Study of Adolescent to Adult Health (Add Health), Waves I & II, 1994–1996; Wave III, 2001–2002; Wave IV, 2007-2009 [machine-readable data file and documentation].
        Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill2009
        • Keel P.K.
        • Baxter M.G.
        • Heatherton T.F.
        • Joiner Jr., T.E.
        A 20-year longitudinal study of body weight, dieting, and eating disorder symptoms.
        Journal of Abnormal Psychology. 2007; 116: 422-432
        • Mayo Clinic
        Pregnancy weight gain: What's healthy?.
        (Available:) (Accessed: April 12, 2016)
        • O'Toole M.L.
        • Sawicki M.A.
        • Artal R.
        Structured diet and physical activity prevent postpartum weight retention.
        Journal of Womens Health (Larchmont). 2003; 12: 991-998
      2. Rasmussen K.M. Yaktine A.L. Weight gain during pregnancy: Reexamining the guidelines. National Academies Press (US), Washington, DC2009
        • Rookus M.A.
        • Rokebrand P.
        • Burema J.
        • Deurenberg P.
        The effect of pregnancy on the body mass index 9 months postpartum in 49 women.
        International Journal of Obesity. 1987; 11: 609-618
        • Rossner S.
        Pregnancy, weight cycling and weight gain in obesity.
        International Journal of Obesity and Related Metabolic Disorders. 1992; 16: 145-147
        • Rossner S.
        • Ohlin A.
        Pregnancy as a risk factor for obesity: Lessons from the Stockholm Pregnancy and Weight Development Study.
        Obesity Research. 1995; 3: 267s-275s
        • Shachar B.Z.
        • Lyell D.J.
        Interpregnancy interval and obstetrical complications.
        Obstetrical & Gynecological Survey. 2012; 67: 584-596
        • Smith D.E.
        • Lewis C.E.
        • Caveny J.L.
        • Perkins L.L.
        • Burke G.L.
        • Bild D.E.
        Longitudinal changes in adiposity associated with pregnancy. The CARDIA Study. Coronary Artery Risk Development in Young Adults Study.
        JAMA. 1994; 271: 1747-1751
        • Villamor E.
        • Cnattingius S.
        Interpregnancy weight change and risk of adverse pregnancy outcomes: A population-based study.
        Lancet. 2006; 368: 1164-1170
        • Villamor E.
        • Cnattingius S.
        Interpregnancy weight change and risk of preterm delivery.
        Obesity. 2016; 24: 727-734
        • Williamson D.F.
        Descriptive epidemiology of body weight and weight change in U.S. adults.
        Annals of Internal Medicine. 1993; 119: 646-649
        • Williamson D.F.
        • Kahn H.S.
        • Remington P.L.
        • Anda R.F.
        The 10-year incidence of overweight and major weight gain in US adults.
        Archives of Internal Medicine. 1990; 150: 665-672
        • Williamson D.F.
        • Madans J.
        • Pamuk E.
        • Flegal K.M.
        • Kendrick J.S.
        • Serdula M.K.
        A prospective study of childbearing and 10-year weight gain in US white women 25 to 45 years of age.
        International Journal of Obesity and Related Metabolic Disorders. 1994; 18: 561-569
        • Wolfe W.S.
        • Sobal J.
        • Olson C.M.
        • Frongillo Jr., E.A.
        • Williamson D.F.
        Parity-associated weight gain and its modification by sociodemographic and behavioral factors: A prospective analysis in US women.
        International Journal of Obesity and Related Metabolic Disorders. 1997; 21: 802-810
        • Wu H.
        • Zhang J.
        Nonparametric regression methods for longitudinal data analysis.
        John Wiley & Sons, Inc, Hoboken, NJ2006


      Olga Yakusheva, PhD, is an Associate Professor at the School of Nursing and the School of Public Health, University of Michigan. Her research interests include health economics, economics of obesity, and economics of fertility.


      Kandice Kapinos, PhD, is an Economist at the RAND Corporation. Her research interests include economic policy, health economics, obesity, and preventive health care.


      Marianne Weiss, DNSC, RN, is a Professor at the College of Nursing, Marquette University. Her research interests include perinatal health care, with an emphasis on postpartum continuum of care and postpartum weight management.