Socioeconomic Differences in Weight Retention, Weight-related Attitudes and Practices in Postpartum Women

  • Vanessa A. Shrewsbury
  • Kathryn A. Robb
  • Chris Power
  • Jane Wardle
Article

Abstract

Objective To determine if there is a socioeconomic status (SES) gradient in postpartum weight retention in women living in the UK, and examine SES differences in weight-related attitudes and practices in the postpartum period. Methods Women (n = 2745) who had full-term live births between July and December 1999 in four London hospitals were eligible to participate in this self-report postal questionnaire study. The questionnaire included items on socio-demographic characteristics, pre-pregnancy weight, postpartum height and weight, pregnancy weight gain and duration, and postpartum weight-related attitudes (body image and weight beliefs) and practices (weight control and weight monitoring). Education was used as the indicator of SES. Results Questionnaires were returned by 954 women (35%) on average eight months postpartum. Median postpartum weight retention was 2.7 kg and was significantly higher in the medium and lower SES women (3.2 kg) than higher SES women (1.8 kg) despite no difference in pregnancy weight gain. A greater proportion of higher SES women believed they would return to their pre-pregnant weight, and they engaged in more frequent weight monitoring. There were no SES differences in body dissatisfaction or the proportion of women trying to lose weight postpartum. Conclusion In the postpartum period, women of higher SES retained less weight than women of lower SES. There were also differences in weight-related attitudes and frequency of weight monitoring across SES groups.

Keywords

Body weight changes Postpartum period Socioeconomic factors 

Notes

Acknowledgements

This research was funded by an Economic and Social Research Council (ESRC) grant. Vanessa A. Shrewsbury, Kathryn A. Robb and Jane Wardle are supported by funding from Cancer Research UK. We thank the women who participated in this study.

Reference

  1. 1.
    Rooney, B. L., Schauberger, C. W., & Mathiason, M. A. (2005). Impact of perinatal weight change on long-term obesity and obesity-related illnesses. Obstetrics and Gynecologyology, 106, 1349–1356.Google Scholar
  2. 2.
    Harris, H. E., & Ellison, G. T. H. (1997). Do the changes in energy balance that occur during pregnancy predispose parous women to obesity? Nutrition Research Reviews, 10, 57–81.PubMedCrossRefGoogle Scholar
  3. 3.
    Gunderson, E. P., & Abrams B. (2000). Epidemiology of gestational weight gain and body weight changes after pregnancy. Epidemiologic Reviews, 22, 261–274.PubMedGoogle Scholar
  4. 4.
    Ohlin, A., & Rossner S. (1994). Trends in eating patterns, physical-activity and sociodemographic factors in relation to postpartum body-weight development. British Journal of Nutrition, 71, 457–470.PubMedCrossRefGoogle Scholar
  5. 5.
    Rossner, S. (1992). Pregnancy, weight cycling and weight gain in obesity. International Journal of Obesity and Related Metabolic Disorders, 16, 145–147.PubMedGoogle Scholar
  6. 6.
    Linne, Y., Dye, L., Barkeling, B., & Rossner S. (2004). Long-term weight development in women: A 15-year follow-up of the effects of pregnancy. Obesity Research, 12, 1166–1178.PubMedCrossRefGoogle Scholar
  7. 7.
    Parker, J. D., & Abrams B. (1993). Differences in Postpartum Weight Retention between Black-And-White Mothers. Obstetrics and Gynecology, 81, 768–774.PubMedGoogle Scholar
  8. 8.
    Institute of Medicine. (1990). Nutrition during pregnancy. Part 1, Weight gain. Washington, DC: National Academy Press.Google Scholar
  9. 9.
    Robinson, H. E., O’Connell, C. M., Joseph, K. S., & McLeod, N. L. (2005). Maternal outcomes in pregnancies complicated by obesity. Obstetrics and Gynecology, 106, 1357–1364.PubMedGoogle Scholar
  10. 10.
    Siega-Riz, A. M., Siega-Riz, A. M., & Laraia B. (2006). The implications of maternal overweight and obesity on the course of pregnancy and birth outcomes. Maternal and Child Health Journal, 10, S153–S156.PubMedCrossRefGoogle Scholar
  11. 11.
    Salsberry, P. J., & Reagan, P. B. (2005). Dynamics of early childhood overweight. Pediatrics, 116, 1329–1338.PubMedCrossRefGoogle Scholar
  12. 12.
    Kac, G., Benicio, M. H., Velasquez-Melendez, G., & Valente, J. G. (2004). Nine months postpartum weight retention predictors for Brazilian women. Public Health Nutrition, 7, 621–628.PubMedCrossRefGoogle Scholar
  13. 13.
    Dugdale, A. E., & Eaton-Evans J. (1989). The effect of lactation and other factors on post-partum changes in body-weight and triceps skinfold thickness. The British Journal of Nutrition, 61, 149–153.PubMedCrossRefGoogle Scholar
  14. 14.
    Sobal, J., & Stunkard, A. J. (1989). Socioeconomic-Status and Obesity - A Review of the Literature. Psychological Bulletin, 105, 260–275.PubMedCrossRefGoogle Scholar
  15. 15.
    Wardle, J., & Griffith J. (2001). Socioeconomic status and weight control practices in British adults. Journal of Epidemiology and Community Health, 55, 185–190.PubMedCrossRefGoogle Scholar
  16. 16.
    Jeffery, R. W., & French, S. A. (1996). Socioeconomic status and weight control practices among 20- to 45-year-old women. American Journal of Public Health, 86, 1005–1010.PubMedCrossRefGoogle Scholar
  17. 17.
    Baker, C. W., Carter, A. S., Cohen, L. R., & Brownell, K. D. (1999). Eating attitudes and behaviors in pregnancy and postpartum: Global stability versus specific transitions. Annals of Behavioral Medicine, 21, 143–148.PubMedCrossRefGoogle Scholar
  18. 18.
    Harris, H. E., Ellison, G. T., & Clement, S. (1999). Relative importance of heritable characteristics and lifestyle in the development of maternal obesity. Journal of Epidemiology and Community Health, 53, 66–74.PubMedCrossRefGoogle Scholar
  19. 19.
    Boyington, J., Johnson. A., & Carter-Edwards, L. (2007). Dissatisfaction with body size among low-income, post-partum black women. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 36, 144–151.PubMedGoogle Scholar
  20. 20.
    Strang, V. R., & Sullivan, P. L. (1985). Body image attitudes during pregnancy and the postpartum period. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 14, 332–337.PubMedCrossRefGoogle Scholar
  21. 21.
    Townsend, P., Phillimore, P., & Beattie A. (1988). Health and Deprivation: Inequality and the north. Kent, England: Croom Helm.Google Scholar
  22. 22.
    Liberatos, P., Link, B. G., & Kelsey, J. L. (1988). The Measurement of Social-Class in Epidemiology. Epidemiologic Reviews, 10, 87–121.PubMedGoogle Scholar
  23. 23.
    World Health Organisation. (1998). Obesity––preventing and managing the global epidemic: Report of a WHO consultation on obesity. Geneva: WHO.Google Scholar
  24. 24.
    Tovee, M. J., Emery, J. L., & Cohen-Tovee, E. M. (2000). The estimation of body mass index and physical attractiveness is dependent on the observer’s own body mass index. Proceedings of Biological Sciences, 267, 1987–1997.CrossRefGoogle Scholar
  25. 25.
    Wardle, J., & Marsland L. (1990). Adolescent concerns about weight and eating; a social-development perspective. Journal of Psychosomatic Research, 34, 377–391.PubMedCrossRefGoogle Scholar
  26. 26.
    SPSS: Statistical Package for the Social Sciences [computer programme]. Version 10.1.0. [computer program]. Chicago: 2000.Google Scholar
  27. 27.
    Scholl, T. O., & Chen X. (2002). Insulin and the “thrifty” woman: The Influence of insulin during pregnancy on gestational weight gain and postpartum weight retention. Maternal and Child Health Journal, 6, 255–261.PubMedCrossRefGoogle Scholar
  28. 28.
    Silventoinen, K., Pankow, J., Jousilahti, P., Hu, G., & Tuomilehto J. (2005). Educational inequalities in the metabolic syndrome and coronary heart disease among middle-aged men and women. International Journal of Epidemiology, 34, 327–334.PubMedCrossRefGoogle Scholar
  29. 29.
    Loucks, E. B., Rehkopf, D. H., Thurston, R. C., & Kawachi I. (2007). Socioeconomic disparities in metabolic syndrome differ by gender: Evidence from NHANES III. Annals of Epidemiology, 17, 19–26.PubMedCrossRefGoogle Scholar
  30. 30.
    Hinton, P. S., & Olson, C. M. (2001). Postpartum exercise and food intake: The importance of behavior-specific self-efficacy. Journal of the American Dietetic Association, 101, 1430–1437.PubMedCrossRefGoogle Scholar
  31. 31.
    Linde, J. A., Jeffery, R. W., French, S. A., Pronk, N. P., & Boyle, R. G. (2005). Self-weighing in weight gain prevention and weight loss trials. Annals of Behavioral Medicine, 30, 210–216.PubMedCrossRefGoogle Scholar
  32. 32.
    Klem, M. L., Wing, R. R., McGuire, M. T., Seagle, H. M., & Hill, J. O. (1997). A descriptive study of individuals successful at long-term maintenance of substantial weight loss. The American Journal of Clinical Nutrition, 66, 239–246.PubMedGoogle Scholar
  33. 33.
    Olson, C. M., Strawderman, M. S., Hinton, P. S., & Pearson, T. A. (2003). Gestational weight gain and postpartum behaviors associated with weight change from early pregnancy to 1y postpartum. International Journal of Obesity, 27, 117–127.PubMedCrossRefGoogle Scholar
  34. 34.
    Brawarsky, P., Stotland, N. E., Jackson, R. A., Fuentes-Afflick, E., Escobar, G. J., Rubashkin, N., & Haas, J. S. (2005). Pre-pregnancy and pregnancy-related factors and the risk of excessive or inadequate gestational weight gain. International Journal of Gynaecology and Obstetrics, 91, 125–31.PubMedCrossRefGoogle Scholar
  35. 35.
    Yelland, J., Brown, S., & Krastev A. (2003). Evaluating innovations in maternity care: Methodological approaches to a baseline postal survey. Birth, 30, 160–167.PubMedCrossRefGoogle Scholar
  36. 36.
    Taylor B. Personal Communication.Google Scholar
  37. 37.
    Department of Health. (2001). Health Survey for England 1999. London: The Stationary Office.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Vanessa A. Shrewsbury
    • 1
  • Kathryn A. Robb
    • 1
  • Chris Power
    • 2
  • Jane Wardle
    • 1
  1. 1.Cancer Research UK Health Behaviour Unit, Department of Epidemiology and Public HealthUniversity College LondonLondonUK
  2. 2.Centre for Paediatric Epidemiology and BiostatisticsInstitute of Child HealthLondonUK

Personalised recommendations