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Gestational Weight Gain and Body Composition Changes during Pregnancy and Early Postpartum Open Access


Other title
Total weight gain recommendations
Physical activity
Energy intake
Resting energy expenditure
Gestational weight gain
Body composition
Type of item
Degree grantor
University of Alberta
Author or creator
Subhan, Fatheema Begum
Supervisor and department
Bell, Rhonda (Agriculture Food and Nutritional Science)
Examining committee member and department
Bell, Rhonda (Agriculture Food and Nutritional Science)
Mager, Diana (Agriculture Food and Nutritional Science)
Eurich, Dean (Public Health Sciences)
Kwalkwarf, Heidi (Pediatrics)
McCargar, Linda (Agriculture Food and Nutritional Science)
Department of Agricultural, Food, and Nutritional Science
Nutrition and Metabolism
Date accepted
Graduation date
Doctor of Philosophy
Degree level
Gestational weight gain (GWG) is associated with short-and long-term maternal and infant health outcomes. The purpose of this research was to describe longitudinal changes in weight and body composition during pregnancy and early postpartum according to pre-pregnancy body mass index (BMI) categories. The contributions of sociodemographic and lifestyle factors and resting energy expenditure (REE) on these changes were examined, and the effects of gaining within and outside the recommended GWG on maternal and infant anthropometrics were studied. Overall, 56% of women exceeded total GWG recommendations; higher rates of weight gain above recommendations were observed among overweight and obese women. GWG was significantly associated with higher postpartum weight retention irrespective of pre-pregnancy BMI; however, overweight and obese women retained a larger quantity of fat mass, particularly in the truncal and abdominal regions, at postpartum. Excessive GWG was positively associated with higher weight at birth and 3 months, and rapid postnatal growth in infants. Other covariates associated with changes in weight and adiposity, were as follows: being nulliparous and having a smoking history were associated with excessive GWG and with a faster rate of fat accumulation in late pregnancy; ethnicity contributed to significant differences in GWG and adiposity; and belonging to a low-income family was associated with higher postpartum weight and fat retention and low birth weight. The sports activity score was a significant predictor of lower fat mass and higher fat-free mass accretion during pregnancy, while REE was positively associated with fat mass, fat free mass and excessive GWG during pregnancy. Longer duration of breast feeding was associated with greater loss of fat mass at postpartum. There was no significant difference in macronutrient intake irrespective of BMI; however, overweight and obese women’s energy intake at trimesters 2 and 3 were significantly less than their estimated energy intake requirements. In sum, this research has shown that excessive GWG plays a significant role in postpartum weight retention and could be a risk factor for incremental weight gain in mother-infants. Effective intervention programs promoting optimal GWG should account for variation in an individual woman’s energy expenditure, dietary intake and the presence of risk factors.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
Citation for previous publication
Begum F, Colman I, McCargar LJ, Bell RC., Gestational weight gain and early postpartum weight retention in a prospective cohort of Alberta women. J Obstet Gynaecol Can. 2012 Jul; 34(7):637-47.

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