576: Excess gestational weight gain leads to post-partum weight retention

Excessive gestational weight gain (GWG) has been linked to post-partum weight retention and long-term adverse health outcomes. We sought to determine if patients at 2 Bronx health clinics with excess GWG by Institute of Medicine (IOM) guidelines were more likely to have post-partum weight retention than those who gained at or under the recommended guidelines. Data are from participants in 2 randomized, controlled trials of pre-natal care based breastfeeding interventions. 941 women with 12-26 week, singleton pregnancies, were enrolled from 2008-2010. Those with pre-pregnancy self-reported weight and height, and a post-partum weight available were included. 2009 IOM guidelines were used to define excess GWG by BMI category. Post-partum weight retention was calculated using a measured weight at the first post-partum visit minus self-reported pre-pregnancy weight. Multivariate analysis of covariance was employed to compare the mean post-partum weight retention by normal v. excess GWG. 404 women met inclusion criteria. Demographic characteristics were similar between groups. Women with excess GWG were more likely to have higher pre-pregnancy BMI (28.6[6.2] v. 27.3[6.2]; p=0.041), deliver at a later gestational age (39.2[1.8] v. 38.6[2.4] weeks; p=0.009) and enroll in WIC (54% v 37%; p=0.001). (Table) In multivariate analysis adjusted for age, parity, race, pre-pregnancy BMI, WIC use, employment, education and the number of weeks post-partum, women gaining within recommended IOM guidelines had retained a mean of 7.2 lbs. at their first post-partum visit, whereas those with excess GWG had mean weight retention of 23.7 lbs, a difference of 16.6 lbs (p<0.001).Tabled 1 In an urban prenatal population, excess GWG was predictive of higher post-partum weight retention regardless of age, weight, BMI, race, socioeconomic indicators, or weeks post-partum. This weight retention can have long-term consequences. This increased risk of weight retention should be added to the list of poor outcomes associated with excess GWG, and interventions are needed to address this issue postpartum.