Maternal Weight Change in Pregnancy is Associated with Women’s Long-term Mortality
Stefanie N. Hinkle, PhD, is an Assistant Professor of Epidemiology in the Department of Biostatistics, Epidemiology and Informatics. Dr. Hinkle’s research in perinatal health integrates nutritional, perinatal, and molecular epidemiology as it relates to maternal nutritional status in pregnancy to optimize the health for women and their children. She received her BS in Molecular, Cell and Developmental Biology from the University of California, Santa Cruz, and her PhD in Nutrition and Health Sciences from Emory University. She then completed a postdoctoral fellowship in the Epidemiology Branch of the Division Intramural Population Health Research at the NICHD.
High weight gain in pregnancy is associated with greater postpartum weight retention; yet the long-term implications remain unknown. Our objective was to assess whether pregnancy weight gain was associated with women’s long-term mortality over 50 years later. The Collaborative Perinatal Project (CPP) Mortality Linkage Study linked maternal participants in the CPP, a prospective pregnancy cohort (1959-1965), to the National Death Index and Social Security Death Master File for vital status through 2016. In this diverse cohort of 46,042 U.S. women with a median follow-up of 52 years ((interquartile range 45-54), 38.9% of women died. Median (interquartile range) total gestational weight change was 9.5 kg (6.4-12.2); 2.5% lost weight during pregnancy. Pregnancy weight change had a U-shaped relationship with long-term mortality. Compared to women with average weight gain (quintile 3), women with weight loss or lowest weight gain (quintile 1), and women with highest weight gain (quintile 5), had a significant 7% and 9% increased mortality risk, respectively. Compared to average weight gain, HRs (95% confidence intervals) for the top four causes of death from cancer, cardiovascular disease, respiratory disease, and diabetes for the first quintile were 1.20 (0.99-1.46), 1.05 (0.96-1.15), 1.14 (0.96-1.37), and 0.92 (0.72-1.17), respectively; HRs for the fifth quintile were 1.19 (0.98-1.45), 1.14 (1.03-1.27), 0.95 (0.78-1.14), and 1.52 (1.20-1.92) respectively. This study’s novel findings reinforce the importance of healthy pregnancy weight gain beyond the pregnancy window to women’s long-term mortality risk, particularly from chronic diseases.
KeywordsPregnancy, Cardiovascular disease, mortality, life course, obesity, weight gain
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