Differences in postpartum weight retention in Caucasian, Oriental and Indian-Subcontinental women, 3 months following a GDM pregnancy.  Causes, and implications for future risk. — ASN Events
  1. Schedule
  2. ADS Clinical Orals: Obesity
  3. Differences in postpartum weight retention in Caucasian, Oriental and Indian-Subcontinental women, 3 months following a GDM pregnancy.  Causes, and implications for future risk.

Differences in postpartum weight retention in Caucasian, Oriental and Indian-Subcontinental women, 3 months following a GDM pregnancy.  Causes, and implications for future risk. (#11)

Steffanie Nario 1 , Allison Sigmund 1 , Susan Hendon 2 , Tien Ming Hng 2 , Jane Zhang 2 , Mark McLean 1 2 , Sue Lynn Lau
  1. University of Western Sydney, Sydney
  2. Blacktown Hospital, Blacktown, NSW, Australia

Background: Postpartum weight retention is associated with adverse cardio-metabolic outcomes. In a Norwegian cohort, Indian-subcontinental women retained more subcutaneous fat postpartum than Caucasians, a potential contributor to subsequent gestational diabetes (GDM).  Reasons for ethnic differences are unclear.

Aim: To determine factors associated with weight retention at 3 months after a GDM pregnancy. To explore the interaction between ethnicity and other factors predicting weight change.

Methods: 142 women were reviewed at 3 months post-GDM pregnancy. Demographics, medical history, food-frequency questionnaire, physical activity, self-reported prepregnancy weight and anthropometric measurements were collected. Postpartum weight retention was calculated as (current weight–prepregnancy weight)*100/prepregnancy weight. One-way Anova and Chi-square tests were performed using SPSS statistics 23, with a significance level of 0.05.

Results: Mean %weight retention was 1.6% in 37 Caucasians versus 4.6% in 30 Orientals and 6.6% in 49 Indian-Subcontinentals (p=0.015). %weight retention was 4.1% in exclusive breast-feeders versus 7.4% in breast and formula-feeders and 2.1% in exclusive formula-feeders (p=0.018). %Weight retention was highest in overweight(7.1%) compared to normal(2.9%) or obese women(2.9%) (p=0.013). Perceived weight category, energy intake, physical activity score, age and parity showed no association with %weight retention. 

Weight gain during pregnancy was higher in Subcontinentals(17%) and Orientals (16%) compared to Caucasians (11%), likely contributing significantly to postpartum differences. Feeding method differed between the 3 ethnicities (p<0.001), with highest rates of formula-feeding in Caucasians(49%) compared to Orientals(17%) and Subcontinentals(8%). Rates of overweight/obesity were 24%/57% in Caucasians, 49%/22% in subcontinentals and 30%/13% in Orientals (p<0.001). Caucasians consumed higher proportional energy from fat compared to Orientals and Subcontinentals (40%, 37%, 34%, p<0.001) with a reverse pattern for %energy from carbohydrates (39%, 42%, 48%, p<0.001).  Subcontinental and Oriental women had higher educational attainment (p<0.01).

Conclusion: Significant differences in demographic make-up, diet, feeding method and anthropometry exist between ethnicities and may explain differing propensity to weight retention. This research informs development of educational strategies to reduce cardio-metabolic risk by targeting pregnancy weight-gain and postpartum weight-loss, particularly in the at-risk Subcontinental population.