Postpartum weight retention and the early evolution of cardiovascular risk

The cumulative effect of postpartum weight retention from each pregnancy can contribute to a woman’s risk of developing type 2 diabetes (T2D) and cardiovascular disease, although direct evidence supporting this is limited. 

The goal of a recent study was to evaluate the impact of postpartum weight retention on cardiovascular risk factors over the first five years after pregnancy.

This prospective observational cohort study included 330 women (mean age 35.7 ± 4.3 years, mean pre-pregnancy BMI 25.2 ± 4.8 kg/m², 50.9% primiparous) who underwent serial cardiometabolic assessments at 1-year, 3-years, and 5-years postpartum. Participants were categorized based on their weight change from pre-pregnancy to 5 years postpartum – weight loss (n = 100), weight gain 0-6% (n = 110), and weight gain ≥ 6% (n = 120).

It was found that at 1-year postpartum, cardiovascular risk factors were similar across groups. However, by 3- and 5-years, an adverse risk profile emerged in the weight retention groups. After adjusting for covariates, there was a stepwise worsening of cardiovascular risk factors at 5 years: triglycerides, HDL, LDL, apolipoprotein-B, Matsuda index, HOMA-IR, fasting glucose, and CRP. Additionally, weight gain ≥ 6% was an independent predictor of pre-diabetes/diabetes at 5-years.

From the results, it was inferred that postpartum weight retention is associated with the progressive emergence of an adverse cardiovascular profile over the first five years after pregnancy. While women with no weight retention initially show no differences in cardiovascular risk factors at 1-year postpartum, by 3- and 5-years, those with weight gain 0-6% and ≥ 6% exhibit worsening cardiometabolic parameters. Weight gain ≥ 6% is also an independent predictor of pre-diabetes/diabetes at 5-years. Thus, postpartum weight retention predicts the early evolution of cardiovascular risk – aligning with its proposed contribution to future vascular disease in women.

Source: Kramer CK, Ye C, Hanley AJ, et al. Cardiovascular Diabetology. 2024 Mar 18;23(1):101.