Postpartum weight retention and breastfeeding among obese women from the randomized controlled Lifestyle in Pregnancy (LiP) trial

Objectives. To study the effects of lifestyle intervention in pregnancy on weight retention 6 months postpartum among obese women from the Lifestyle in Pregnancy (LiP) study, and to determine associations between breastfeeding with postpartum maternal weight. Design. Six months postpartum follow up after a randomized controlled intervention trial. Setting. Two university hospitals in Denmark. Population. A total of 360 women with pregestational body mass index >= 30 kg/m(2). Methods. The intervention involved lifestyle changes (diet and exercise) during pregnancy. The control group received routine pregnancy care. Both groups received standard postnatal care. Main outcome measures. Gestational weight gain, postpartum weight retention and breastfeeding. Results. Follow up was completed in 238 women of whom 46% in the intervention group and 57% in the control group had retained weight 6 months postpartum (p = 0.088). Women with gestational weight gain <= 9 kg, (recommended by the Institute of Medicine), retained less postpartum weight compared with those who exceeded 9 kg (median -0.7 vs. 1.5, p < 0.001). Ninety-two percent in both weight gain groups initiated breastfeeding. The number of breastfeeding mothers was higher among women with postpartum weight retention = 5 kg compared with those with weight retention > 5 kg (94% vs. 85%, p = 0.034). Conclusions. We could not detect sustained weight control at 6 months postpartum despite a lower gestational weight gain for obese women during pregnancy who received a lifestyle intervention rather than standard care. Women who adhered to gestational weight gain recommendations had significantly lower postpartum weight retention. Breastfeeding for 6 months was negatively associated with postpartum weight retention.