Excessive weight gain during pregnancy and substantial weight maintenance after delivery are common among military health care beneficiaries

Compared with their civilian counterparts, excessive weight gain during pregnancy is more common among military health care beneficiaries, particularly active duty personnel, and is associated with costly maternal/neonatal complications. Women in this sample with excessive weight gain during pregnancy were also three times more likely to have substantial weight maintenance after delivery, according to a new study published in the journal Obesity.

Significant weight maintenance 12 months postpartum was also more common among military health care beneficiaries in this sample than previously documented in civilian samples. Weight maintenance after childbirth is a major concern for the U.S. military because it affects the ability of active-duty women to pass their fitness tests and has also been linked to long-term maternal overweight and obesity.

“These results highlight the importance of weight management before, during, and after pregnancy for military populations, given the high health care costs of weight-related health complications that affect mother and baby, as well as the importance of maintaining fitness in the active-duty population. said Rebecca Krukowski, Ph.D., professor, Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia. Krukowski is the corresponding author of the study.

Data on military health care beneficiaries were obtained from the Military Health System Data Repository. More than 48,000 women who gave birth in 2018 and 2019 were included. Researchers examined the relationships between overweight and obesity, weight gain during pregnancy, maternal and neonatal complications, and substantial weight maintenance after delivery.

Weight gain during pregnancy was determined by the amount of weight gained between the measured pre-pregnancy weight and the delivery weight. The amount of weight gain during pregnancy was then compared to the National Academy of Medicine’s national guidelines for weight gain during pregnancy.

For body mass index, women were classified into four categories: underweight, healthy, overweight and obese, based on their pre-pregnancy weight and height. Substantial postpartum weight retention was defined as retention of at least 10 pounds 12 months postpartum, compared to weight before conception. Clinical outcomes potentially related to gestational weight gain and body mass index were extracted from maternal and newborn health care records.

For maternal clinical outcomes, cases of preeclampsia, pregnancy-induced hypertension, gestational diabetes, and cesarean delivery were identified. For neonatal outcomes, researchers identified infants who experienced intrauterine growth restriction, were small or large for gestational age, had low birth weight, and had a neonatal intensive care unit admission.

Results showed that 75% of TRICARE beneficiaries had excessive weight gain during pregnancy. Military spouses and other family members were less likely than active duty women to have excessive weight gain during pregnancy. Those with excessive gestational weight gain and/or overweight or obesity were more likely to experience maternal complications such as pregnancy-induced hypertension and cesarean section. The findings also showed that 42% of military beneficiaries had substantial weight retention postpartum.

In addition, women with excessive weight gain during pregnancy were three times as likely to maintain substantial weight after delivery. Researchers add that pregnancy-related weight gain above national guidelines and substantial weight retention after childbirth can make it challenging to regain the required fitness level for active duty women and for these women (who want to serve their country) to continue their careers in the military to keep. .