Associations of pre-pregnancy weight, gestational weight gain, and postpartum weight retention with metabolic health: Findings from the MISC cohort study
Maryam Alameddine, Hadia Radwan, Nada Abbas, Mona Hashim, Katia Hazim, Hayder Hasan, Reyad S. Obeid, Hessa Ghazal, Sara Mohammed Ahmed Rady, Marwa Al Hilali, Farah NajaBackground
Maternal weight before, during, and after pregnancy is associated with postpartum metabolic health; however, the independent contributions of these weight indicators remain insufficiently examined.
Objectives
This study assessed the associations of pre-pregnancy Body Mass Index (BMI), gestational weight gain (GWG), and postpartum weight retention (PPWR) with metabolic outcomes.
Design
We analyzed data from a prospective cohort of pregnant women followed to 6 months postpartum in the United Arab Emirates (UAE).
Methods
A total of 256 women were recruited during their third trimester of gestation from Primary Health Clinics and Mother and Child Centers. Weight information was obtained for three time points: before pregnancy, at delivery, and 6 months postpartum. Blood biomarkers (lipids, insulin, glucose, and inflammatory markers) were measured at 6 months postpartum. Multivariate logistic regression assessed the associations between weight indicators and each metabolic outcome, as well as with having ≥3 abnormal/elevated outcomes, based on the population median of three.
Results
Pre-pregnancy overweight/obesity (59.4%) was significantly associated with elevated insulin (OR=3.91, CI: 1.36-11.24), interleukin-6 (OR=5.11, CI: 1.71-15.28), CRP (OR=5.34, CI: 1.58-18.01), LDL (OR=2.89, CI: 1.08-7.74) and total cholesterol (OR=3.05, CI: 1.14-8.15). Among participants, 85.1% had inappropriate GWG, and 73.2% retained some weight postpartum. GWG was associated only with elevated TNF-α, while PPWR was linked to elevated fasting serum glucose. The odds of having ≥3 metabolic abnormalities were significantly higher among women with elevated pre-pregnancy BMI (OR=3.44, CI: 1.36–8.68).
Conclusion
Among the three weight indicators examined, pre-pregnancy BMI showed the most consistent associations with postpartum metabolic biomarkers. These findings suggest that achieving a healthy weight before pregnancy may be an important target for reducing cardiometabolic risk.