Maternal prepregnancy waist circumference and BMI in relation to gestational weight gain and breastfeeding behavior: the CARDIA study

TY - JOUR

T1 - Maternal prepregnancy waist circumference and BMI in relation to gestational weight gain and breastfeeding behavior

T2 - the CARDIA study

AU - Kirkegaard, Helene

AU - Nohr, Ellen A

AU - Rasmussen, Kathleen M

AU - Stovring, Henrik

AU - Sørensen, Thorkild I A

AU - Lewis, Cora E

AU - Gunderson, Erica P

N1 - © 2015 American Society for Nutrition.

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Background: Studies suggest that gestational weight gain (GWG) and breastfeeding behavior may influence long-term maternal abdominal fat mass. However, this could be confounded by abdominal fat mass before pregnancy because it is unknown whether abdominal fat mass, independently of body size, affects GWG and breastfeeding behavior. Objective: We investigated how maternal prepregnancy fat distribution, described by waist circumference (WC) and body mass index (BMI), is associated with GWG and breastfeeding behavior. Design: We analyzed 1371 live births to 1024 women after enrollment in the Coronary Artery Risk Development in Young Adults study (1985-1996). For each birth, maternal prepregnancy BMI and WC were measured at year 0 (baseline), 2, 5, or 7 examinations. Recalled GWG and breastfeeding behavior were collected at years 7 and 10. GWG was analyzed by using linear regression and breastfeeding behavior by using logistic regression and discrete-time logistic regression. Results: Adjusted for potential confounders, a 1-cm larger WC adjusted for BMI was associated with a 0.19-kg (95% CI: 20.29-, 20.10-kg) lower GWG. In contrast, a 1-unit higher BMI adjusted for WC was associated with a 0.27-kg (95% CI: 0.06-, 0.47-kg) higher GWG. The OR for ever breastfeeding compared with never breastfeeding was 0.93 (95% CI: 0.90, 0.97) per 1-cm larger WC after adjustment for BMI, whereas it was 1.10 (95% CI: 1.02, 1.19) per 1-unit higher BMI adjusted for WC. Conclusions: Maternal prepregnancy body size was differently associated with GWG and breastfeeding behavior depending on the location of the fat mass. Thus, maternal fat distribution may be a more important determinant of GWG and breastfeeding behavior than BMI alone.

AB - Background: Studies suggest that gestational weight gain (GWG) and breastfeeding behavior may influence long-term maternal abdominal fat mass. However, this could be confounded by abdominal fat mass before pregnancy because it is unknown whether abdominal fat mass, independently of body size, affects GWG and breastfeeding behavior. Objective: We investigated how maternal prepregnancy fat distribution, described by waist circumference (WC) and body mass index (BMI), is associated with GWG and breastfeeding behavior. Design: We analyzed 1371 live births to 1024 women after enrollment in the Coronary Artery Risk Development in Young Adults study (1985-1996). For each birth, maternal prepregnancy BMI and WC were measured at year 0 (baseline), 2, 5, or 7 examinations. Recalled GWG and breastfeeding behavior were collected at years 7 and 10. GWG was analyzed by using linear regression and breastfeeding behavior by using logistic regression and discrete-time logistic regression. Results: Adjusted for potential confounders, a 1-cm larger WC adjusted for BMI was associated with a 0.19-kg (95% CI: 20.29-, 20.10-kg) lower GWG. In contrast, a 1-unit higher BMI adjusted for WC was associated with a 0.27-kg (95% CI: 0.06-, 0.47-kg) higher GWG. The OR for ever breastfeeding compared with never breastfeeding was 0.93 (95% CI: 0.90, 0.97) per 1-cm larger WC after adjustment for BMI, whereas it was 1.10 (95% CI: 1.02, 1.19) per 1-unit higher BMI adjusted for WC. Conclusions: Maternal prepregnancy body size was differently associated with GWG and breastfeeding behavior depending on the location of the fat mass. Thus, maternal fat distribution may be a more important determinant of GWG and breastfeeding behavior than BMI alone.

KW - Adiposity

KW - Adolescent

KW - Adult

KW - Body Mass Index

KW - Breast Feeding

KW - Cohort Studies

KW - Coronary Artery Disease

KW - Female

KW - Humans

KW - Longitudinal Studies

KW - Maternal Nutritional Physiological Phenomena

KW - Obesity

KW - Obesity, Abdominal

KW - Overweight

KW - Pregnancy

KW - Pregnancy Complications

KW - Risk Factors

KW - United States

KW - Waist Circumference

KW - Weight Gain

KW - Young Adult

U2 - 10.3945/ajcn.114.099184

DO - 10.3945/ajcn.114.099184

M3 - Journal article

C2 - 26135344

SN - 0002-9165

VL - 102

SP - 393

EP - 401

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

IS - 2

ER -