Study Highlights Importance of Weight Control Before and After Pregnancy for Military Members

Study Highlights Importance of Weight Control Before and After Pregnancy for Military Members

Compared to their civilian counterparts, excessive weight gain during pregnancy is more common among military health care recipients, particularly active duty personnel, and is associated with costly maternal and newborn complications. Women in this sample who gained excessive weight during pregnancy were also three times more likely to have significant postpartum weight gain, according to a new study published in the journalobesitythe flagship journal of the Obesity Society (TOS).

Significant weight maintenance at 12 months postpartum was also more common among military health care recipients in this sample than previously documented in civilian samples. Postpartum weight maintenance is a key concern for the U.S. military because it impacts the ability of active-duty women to pass their fitness tests and is also linked to long-term maternal overweight and obesity.

These results highlight the importance of weight management before, during and after pregnancy for military personnel given the high healthcare costs of weight-related health complications in mother and child and the importance of maintaining fitness in the active duty population.”

Rebecca Krukowski, PhD, Professor, Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia.

Krukowski is the corresponding author of the study.

Data for military health care beneficiaries were obtained from the Military Health System Data Repository. More than 48,000 women who gave birth to children in 2018 and 2019 were included. Researchers examined links between overweight and obesity, weight gain during pregnancy, maternal and newborn complications, and significant postpartum weight maintenance.

Pregnancy weight gain was determined by weight gain between measured pre-pregnancy weight and delivery weight. The extent of weight gain during pregnancy was then compared to the National Academy of Medicine's national guidelines for weight gain during pregnancy. For body mass index, women were divided into four categories based on their pre-pregnancy weight and height: underweight, healthy, overweight and obese. Significant postpartum weight maintenance was defined as maintaining at least 10 pounds 12 months postpartum compared to preconception weight. Clinical outcomes potentially related to gestational weight gain and body mass index were abstracted from maternal and neonatal health records. For maternal clinical outcomes, cases of preeclampsia, pregnancy-induced hypertension, gestational diabetes, and cesarean delivery were identified. For neonatal outcomes, researchers identified infants who experienced intrauterine growth restriction, were small or large for gestational age, had low birth weight, and were treated in the neonatal intensive care unit.

Results showed that 75% of TRICARE beneficiaries experienced excessive weight gain during pregnancy. Military members and other family members were less likely to experience excessive weight gain during pregnancy than active-duty women. Those who experienced excessive weight gain during pregnancy and/or were overweight or obese were more likely to experience maternal complications such as pregnancy-related hypertension and cesarean delivery. The results also showed that 42% of military personnel had significant postpartum weight retention. Additionally, women who gained excessive weight during pregnancy were three times more likely to have significant postpartum weight maintenance. Researchers add that pregnancy-related weight gain in excess of national guidelines and significant postpartum weight maintenance may make it difficult for active-duty women and for those women (who want to serve their country) to maintain their careers in the military to regain required fitness levels.

Additional authors of the study are Wen You and Carol Copeland, Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia. Copeland is also with the 59th Medical Wing, Clinical Health Psychology, Joint Base San Antonio, Texas. Erin Solomon, Department of Psychology, University of Memphis, Memphis, Tennessee; Juan Lang, Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, Kentucky; Emily Stone, Geneva Foundation, Bethesda, Md.; Rosemary Estevez Burns, 59th Medical Wing, Clinical Health Psychology, Joint Base San Antonio, Texas; Zoran Bursac, Department of Biostatistics, Florida International University, Miami, Florida; Marion E. Hare, Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; and Teresa M. Waters, Augusta University, Institute for Public and Preventive Health, Augusta, Georgia.

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