Postpartum Weight Retention Among Mothers of Children with Special Health Care Needs

Background: Postpartum weight retention (PPWR) is a risk factor for subsequent obesity among women.  The perinatal period is a complex time for maternal and child health, as demands of parenting arise alongside dramatic changes in physiology.  We sought to assess whether there was an association between having a child with a special health care need (CSHCN), and maternal PPWR. 

Methods: This study uses data from the 2005 Oregon Pregnancy Risk Assessment Monitoring System (PRAMS). Oregon PRAMS is a stratified random sample of live births that asks women about their attitudes and experiences before, during, and after pregnancy. PRAMS-2 re-interviews PRAMS respondents shortly after the child turns 2 years old.  The primary predictor was CSHCN status.  The outcome was high PPWR, defined as retention of more than 4.5 kg.  Logistic regression modeling estimated the main association.

Results:  In the final sample of 978 subjects, 11.4% women reported having a CSHCN and 41.3% reported high PPWR.  The odds of reporting PPWR among subjects with CSHCN were 1.98 times those of subjects without CSHCN, after adjustment for parity, pregravid BMI, maternal race/ethnicity, maternal age, breastfeeding, physical activity, food security status, household income, and maternal depression in multivariate logistic regression analysis (OR: 1.98 95% CI: 1.07 – 3.66)

Conclusions:  Compared to women who did not have a CSHCN, women who had a CSHCN were less likely to return to their pre-pregnancy weight. Public health professionals can use these findings to develop ways to improve primary and secondary prevention of obesity in new mothers.