(PO16-36-22) Long-Term Mortality Implications of Maternal Weight Change in Pregnancy

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Presenting Author(s)

Stefanie N. Hinkle, PhD
– Assistant Professor, University of Pennsylvania, PHILADELPHIA, Pennsylvania, United States

Co-Author(s)

SM

Sunni L. Mumford
– University of Pennsylvania
KG

Katherine Grantz, MS, MD
– Investigator, NIH/NICHD, Bethesda, Maryland, United States
PM

Pauline Mendola
– University of Buffalo
JM

James Mills, MD, MS
– NICHD, National Institutes of Health, Bethesda, Maryland, United States
EY

Edwina H. Yeung, PhD
– Senior Investigator, NIH/NICHD, Bethesda, Maryland, United States
AP

Anna Pollack
– George Mason University
SG

Sonia Grandi
– Sick Kids
YQ

Yan Qiao
– Glotech
RS

Rajeshwari Sundaram
– NICHD
ES

Enrique Schisterman
– University of Pennsylvania
CZ

Cuilin Zhang, MD, PhD
– Senior Investigator, National Intitute of Child and Human Development, NIH, Bethesda, Maryland, United States

Disclosure(s):

Stefanie N. Hinkle, PhD: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: High pregnancy weight gain is associated with greater postpartum weight retention; yet the long-term implications remain unknown. We examined associations of pregnancy weight change with mortality after ~50 years of follow-up.

Methods: The Collaborative Perinatal Project (CPP) Mortality Linkage Study linked maternal participants in the CPP, a prospective pregnancy cohort (1959-1965), to the National Death Index and Social Security Death Master File for vital status through 2016 (n=46,042). Total gestational weight change (gain or loss) in the index pregnancy (last CPP singleton pregnancy) was the difference in recorded delivery weight and self-reported pre-pregnancy weight. All-cause and cause-specific mortality associations with quintiles of gestational weight change were estimated using Cox regression adjusting for index pregnancy age, pre-pregnancy body mass index (BMI), race, parity, smoking, marital status, income, education, site, study year, prior chronic conditions, and gestational week at delivery.

Results: Majority of women (69%) had a healthy pre-pregnancy BMI and 46% were White and 45% were Black. Median (interquartile range) total gestational weight change was 9.5 kg (6.4-12.2), respectively; 2.5% lost weight in pregnancy. Over a median follow-up of 52 years (IQR 45-54), 38.9% of women died. Adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for mortality across quintiles 1 to 5 were 1.07 (95% CI 1.01-1.12), 1.03 (0.98-1.09), 1.00 (Reference), 1.01 (0.96-1.07), and 1.09 (1.03- 1.14), respectively. Compared to the middle quintile, HRs for the top four causes of death, cancer, cardiovascular disease, respiratory disease, and diabetes for the first quintile were 1.20 (0.99-1.46), 1.05 (0.96-1.15), 1.14 (0.96-1.37), and 0.92 (0.72-1.17), respectively; HRs for the fifth quintile were 1.19 (0.98-1.45), 1.14 (1.03-1.27), 0.95 (0.78-1.14), and 1.52 (1.20-1.92) respectively.

Conclusions: This study’s novel findings extend the importance of healthy pregnancy weight gain beyond the pregnancy window to women’s long mortality risk, particularly from cancer, cardiovascular disease, and diabetes.

Funding Sources: This work was funded by the Intramural Research Program of the NICHD.