BACKGROUND: Postpartum weight retention is a trigger for developing obesity in women. It is often associated with weight gain during pregnancy, parity, age, marital status, food intake, physical activity and lactation. However, the associations found have proven to be inconclusive or contradictory. OBJECTIVES: The purpose of this review was to study risk factors associated with postpartum weight gain and retention. METHODS: A systematic review of the literature between January 1993 and June 2003 was performed through Medline and LILACS databases. RESULTS: Twenty-eight studies were found: 23 cohort studies, four cross-sectional studies and one case-control study. Most studies were performed in the US and the postpartum follow-up time was mainly between six weeks and 24 months. Twenty five percent of the studies had loss to follow-up above 30%, 61% included adolescents and 75% used self-reported pregravid body weights. The most reliable results came from seven studies, whose strengths were: use of measured pregravid body weight and comparison groups, exclusion of adolescents, loss to follow-up rates below 30% and adequate control for confounders. CONCLUSION: Gestational weight gain, black women and parity are positively associated with postpartum weight retention. The effect of lactation on weight retention is still controversial and there is lack of evidence on physical activity and food intake. Improved longitudinal studies are needed to clarify theses issues.
Systematic review; Obesity; Postpartum; Body weight; Risk factors
