182372 Provider advice about weight loss and physical activity in the postpartum period

Wednesday, October 29, 2008

Renée M. Ferrari, MPH , Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
Anna Maria Siega-Riz, PhD, MS, RD , Nutrition, Epidemiology, and Carolina Population Center, The University of North Carolina, Chapel Hill, NC
Kelly R. Evenson, PhD , Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC
Merry-K. Moos, FNP, MPH , Department of Obstetrics and Gynecology, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC
Cathy L. Melvin, PhD , Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, Chapel Hill, NC
Amy Herring, PhD , Biostatistics, Unversity of North Carolina at Chapel Hill, Chapel Hill, NC
Postpartum weight retention may be an important contributor to the overweight/obesity epidemic among reproductive-age women. Provider advice influences health behavior but this has yet to be demonstrated during the postpartum period. Using data from a longitudinal cohort study, we explored the association between weight loss and physical activity advice with weight retention and activity levels in 688 women at 3 months postpartum. Data from home study visits included anthropometric measurements and socio, demographic, health behavior, and psycho-social questionnaires. Weight retention was calculated as weight at 3 months postpartum minus pre-pregnancy weight; activity levels and advice were based on maternal self-report. Linear and poisson regression were used to explore associations. Most women reported receiving no weight loss advice (76.2%) and no physical activity advice (63.7%) during the postpartum period (at 3 months). After adjustment, we found no association between advice and weight retention of 5.1-10 lbs (RR 1.09, 95% CI 0.69, 1.72); >10 lb retention varied by pre-pregnancy BMI but also showed little association with advice. Women who reported following provider advice about physical activity had 45 minutes more of recreational activity/week compared to those reporting no advice (p=0.06, 95% CI -0.1, 1.6), while those who reported not following advice had 22 fewer minutes of activity (p=.6, 95% CI -1.7, 0.9). Our findings suggest that provider advice may influence physical activity but may not be enough to help postpartum women lose pregnancy weight. Instead, women may benefit more from individualized counseling and follow-up beyond the usual 6-week postpartum.

Learning Objectives:
1. Understand the public health significance of postpartum weight retention. 2. Identify two determinants of postpartum weight retention and two determinants of physical activity postpartum. 3. Recognize the need for improved understanding of the role of provider advice in weight loss and physical activity during the postpartum period.

Keywords: Maternal Health, Providers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I performed the analysis and wrote the paper.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.