EXCESSIVE GESTATIONAL WEIGHT-GAIN AND CHRONIC DISEASE RISK

Excessive deposition of central body and abdominal (centripetal) fat e arly in life often will presage the later development of cardiovascula r and metabolic diseases. Data from urban, low-income women from Camde n, New Jersey, were used to examine the influence of gestational weigh t gain on patterns of weight change and fat deposition in 118 young wo men followed over two consecutive pregnancies. Adjusting for confoundi ng factors, there was a significant (P < 0.05) dose-response relations hip between the amount of gestational gain (in the subsequent pregnanc y) and increases in postpartum weight compared with the postpartum in the prior pregnancy: +1.5 kg with a low gain, +2.9 kg with recommended amounts of gain, and +7.9 kg with excessive gain. Excessive gain (18 kg) was common (18%) in the sample. The incidence of ''new'' obesity (body mass index [BMI] >29.0 in the subsequent postpartum but not the index postpartum) increased significantly with gestational gain: 4.7% with low gain, 7.0% with recommended gains, and 25.0% with excessive g ain. There were similar dose-response increases related to gestational weight gain in all skinfolds (suprailiac, subscapular, and triceps) a nd the sum of the skinfolds. However, in women with excessive gains, f at was increased disproportionately at upper (+52%) and lower (+48%) c entral body sites, compared with the periphery (+27%), and compared wi th increases in women with lesser gestational gains. Thus, excessive g estational weight gain, which is common among low-income women, may be a factor which promotes obesity and a centripetal fat pattern during the reproductive years, thereby increasing the risk for cardiovascular and metabolic diseases in later life. (C) 1996 Wiley-Liss, Inc.