A Postpartum Weight Loss-focused Stepped-care Intervention in a Military Population: A Randomized Controlled Trial

Postpartum Weight Management Experiences of Ghanaian Women: A Qualitative Inquiry

OBJECTIVE

To explore postpartum weight management experiences of Ghanaian women.

DESIGN

Phenomenological qualitative study using in-depth interviews.

SETTING

Six health care centers in Cape Coast, Ghana.

PARTICIPANTS

Twenty-eight women were recruited through consecutive sampling.

PHENOMENON OF INTEREST

Themes regarding postpartum weight management experiences.

ANALYSIS

Braun and Clarke's reflective thematic analysis method was employed.

RESULTS

Three themes emerged: (1) body weight concerns, (2) dietary modifications, and (3) moderators of weight management decisions. Participants expressed distress over postpartum weight changes and longed to return to their prepregnancy size. However, they were hindered by child care responsibilities and a lack of clear guidance. Many participants postponed weight management efforts until breastfeeding demands lessened. Dietary modifications included reducing sugar intake, using herbal remedies, and adjusting meal timing. Moderators such as health care providers and social networks informed the participants of weight management efforts. Participants often relied on self-directed strategies informed by cultural beliefs and social networks because of inadequate professional advice.

CONCLUSIONS AND IMPLICATIONS

Our results suggest several opportunities for health care professionals, peers, and families to support women in the postpartum period to manage their weight. Further studies could explore strategies that can be used to support women in their postpartum period to manage and address their body weight concerns.

Impact of postpartum physical activity on maternal anthropometrics: a systematic review and meta-analysis

OBJECTIVE

This systematic review and meta-analysis examined the relationship between postpartum exercise and maternal postpartum anthropometrics.

DESIGN

Systematic review with random-effects meta-analysis and meta-regression.

STUDY ELIGIBILITY CRITERIA

Online databases were searched from database inception until 12 January 2024. Randomised controlled trials (RCTs) written in any language were eligible if they contained information on the population (postpartum women and people); intervention (frequency, intensity, duration, volume or type of exercise, alone ('exercise-only') or in combination with other interventions (eg, dietary; 'exercise+cointervention')); comparator (no exercise) and outcomes (anthropometric measures including weight, postpartum weight retention (PPWR), body mass index (BMI), fat mass, lean body mass (LBM), body fat percentage, waist circumference, hip circumference or waist-hip ratio).

RESULTS

64 RCTs (n=12 684 participants) from 20 countries were included. Moderate to high certainty of evidence showed that exercise-only interventions reduced weight by 1.34 kg (18 studies, n=771; 95% CI -2.06 to -0.61, I2 0%), BMI by 0.73 kg/m2 (14 studies, n=662; 95% CI -1.21 to -0.25, I2 60%) and fat mass by 1.55 kg (5 studies, n=135; 95% CI -3.01 to -0.09, I2 0%) compared with no exercise. The duration of the exercise interventions ranged from 3 months to 3 years. Dose-response analysis found 560 MET-min/week of exercise (eg, 120 min/week of brisk walking) was associated with 1 kg/m2 reduction in BMI. Low certainty of evidence showed that exercise-only interventions had no effect on LBM (5 RCTs, n=135; standardised mean difference -0.13; 95% CI -0.48, 0.21, I2 0%) compared with no exercise.

CONCLUSIONS

These findings highlight physical activity as an effective intervention to improve postpartum anthropometrics and reduce PPWR.

PROSPERO REGISTRATION NUMBER

CRD42022359282.

A Quasi-Experiment of Self-Weight Combined with Dietary and Physical Activity to Reduce Postpartum Weight Retention

Background

The failure to lose postpartum weight retention (PPWR) can impact obesity in later life, making programs aimed at reducing PPWR crucial. The study aimed to assess the effect of a self-weight approach combined with dietary and physical activity interventions to reduce PPWR.

Materials and Methods

This quasi-experimental study employed a three-group, pretest-posttest design. The study recruited 178 postpartum mothers who attended a 6-week postpartum check-up at a university hospital in Chiang Mai, Thailand, from 2018 to 2020. Data was collected using a self-administered questionnaire. The intervention groups received dietary counseling combined with self-weighting (D) and diet and physical activity counseling combined with self-weighting (DP), while the control group received standard care. Analysis of covariance was used for data analysis, with pre-pregnancy weight as the covariance.

Results

PPWR was 3.39 kg for the D group, 3.20 kg for the DP group, and 4.14 kg for the control group (F (2,174) =1.91, p > 0.05). At 6 months postpartum, on comparing self-weighting and non-self-weighting groups, it was found that PPWR was 2.88 and 3.99 kg for the self-weighting and non-self-weighting groups, respectively (t 176= -2.28, p = 0.024).

Conclusions

The study results indicated that dietary or combined dietary and physical activity counseling for postpartum mothers is necessary. For optimal success, postpartum mothers should be encouraged to undertake daily or weekly self-weighing to reduce PPWR.

Effect of mode of delivery on postpartum weight retention: A systematic review and meta-analysis

OBJECTIVE

Retention of weight gained over pregnancy increases the risk of long-term obesity and related health concerns. While many risk factors for this postpartum weight retention have been examined, the role of mode of delivery in this relationship remains controversial. We carried out a systematic review and meta-analysis to determine the effect of mode of delivery on postpartum weight retention.

METHODS

Ten electronic databases including PubMed, Cochrane Library, EMBASE, Web of Science, MEDLINE, CINAHL, China National Knowledge Infrastructure (CNKI), Wan-Fang database, the VIP database and China Biology Medicine Database (CBM) were searched from inception through November 2022. Review Manager 5.4 was used to pool the study data and calculate effect sizes. For dichotomous data, the odds ratio and 95 % confidence interval were used to report the results. For continuous data, the mean difference (MD) and 95 % confidence interval were used to report the results. The outcomes were the amount of postpartum weight retention and the number or proportion of women who experienced postpartum weight retention. The Newcastle- Ottawa Scale (NOS) and GRADE Guidelines were used to assess the methodological quality of the included studies.

FINDINGS

A total of 16 articles were included in the systematic review and 13 articles were included in the meta-analysis. The results showed that the mode of delivery had a significant effect on postpartum weight retention, women who delivered by caesarean section were more likely to experience postpartum weight retention compared to those who delivered vaginally. Sensitivity analysis showed that the results were stable and credible.

CONCLUSION

Due to the limitations of this study, the findings need to be treated with caution. And, to better prevent the postpartum weight retention, future practice and research need to further focus on upstream modifiable factors.