(205) Postpartum Weight Retention Trajectories in Women with Prior Gestational Diabetes

Postpartum weight retention (PPWR) is a known risk factor for type 2 diabetes among women with prior gestational diabetes (GDM). Although breastfeeding may support postpartum metabolic recovery, its influence on weight trajectories in this population remains unclear. This study evaluated 5-year PPWR trajectories and the impact of early postpartum breastfeeding intensity.


Study Design:

This longitudinal study included 521 women with prior GDM who delivered singleton pregnancies at a Japanese tertiary perinatal center. PPWR was calculated as postpartum weight minus prepregnancy weight and assessed at early postpartum and at 1, 2, 3, and 5 years. Women were categorized by early PPWR level (high: >=75th percentile vs. low: < 75th) and by breastfeeding intensity (high-intensity breastfeeding [HIB] vs. non-HIB). Multivariable linear models adjusted for prepregnancy BMI, gestational weight gain (GWG), maternal age, time of assessment, and delivery mode were used to compare mean PPWR trajectories.


Results:

Women with high early PPWR ( >=75th percentile) had persistently higher PPWR at all time points through 5 years (p < 0.001). The gap in weight retention between high and low early PPWR groups widened over time. In contrast, breastfeeding intensity showed no significant association with PPWR at any point, including at 5 years (Figure). Among covariates, early PPWR and GWG were the most robust predictors of long-term weight retention.


Conclusion:

Early postpartum weight retention strongly predicts long-term maternal weight retention in women with prior GDM. Despite its other benefits, breastfeeding intensity did not significantly influence PPWR trajectories. Interventions targeting women with high early PPWR, regardless of breastfeeding status, may be key to preventing prolonged weight retention and its cardiometabolic consequences.