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

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.