(307) Beyond the Bump: Trauma’s Lasting Impact on Postpartum Weight

Postpartum weight retention (PPWR), weight retained after delivery compared to pre-pregnancy weight, is a key predictor of adverse long-term cardiometabolic outcomes. While prior studies have linked trauma exposure to weight dysregulation in non-pregnant populations, impacts of trauma exposure on PPWR remain poorly understood. Given the established cardiac risks associated with increased PPWR, we sought to evaluate the association between various trauma exposure domains & PPWR.

Study Design:

We performed a secondary analysis of a prospective longitudinal cohort study investigating associations between trauma exposures & pregnancy outcomes at an urban safety net hospital. Childhood trauma (CT), Post-Traumatic Stress (PTSD), Lifetime Stress (LS), Adult Trauma (AT), & Postnatal Depression (PD) were captured using validated trauma exposure questionnaires (Table 1). Maternal weight was recorded in each trimester & at 30 (30d) & 42 (42d) days postpartum. PPWR was calculated at 30d (30d weight-initial 1^st trimester weight) and 42d (42d weight-initial 1^st trimester weight). Linear regression models were conducted to investigate associations between trauma exposure scores & PPWR, adjusting for maternal age and body mass index.

Results:

In our cohort of N=328, CT (b=0.33, 95% CI 0.07-0.60, p=0.015), PTSD (b=0.29, 95% CI 0.03-0.55, p=0.031), & LS (b=1.93, 95% CI 0.63-3.22, p=0.004) were associated with PPWR at 30d (Figure 1). There was no association between AT & PPWR (p=0.24). A trend was observed between PD & PPWR (b=0.75, 95% CI -0.02-1.5, p=0.05). At 42d, associations between CT (b=0.41, 95% CI 0.06-0.76, p=0.02) & LS (b=2.05, 95% CI 0.14-3.96, p=0.03) & PPWR remained significant. Interestingly, at 42d, PD was significantly associated with PPWR (b=1.27, 95% CI 0.11-2.4, p=0.03) whereas PTSD (p=0.08) & AT (p=0.29) were not.

Conclusion:

Our data innovatively demonstrate that trauma exposure, & specific subtypes of trauma, significantly impact PPWR. As the paradigm of postpartum care evolves, incorporating trauma-informed strategies is essential to reduce long-term maternal cardiometabolic risk.