The cumulative effect of postpartum weight retention from each pregnancy in a woman’s life may contribute to her risk of ultimately developing type 2 diabetes and cardiovascular disease. However, there is limited direct evidence supporting this hypothesis. Thus, we sought to characterize the impact of postpartum weight retention on the trajectories of cardiovascular risk factors over the first 5-years after pregnancy. In this prospective observational cohort study, 330 women (mean age 35.7 ± 4.3 years, mean pre-pregnancy body mass index 25.2 ± 4.8 kg/m2, 50.9% primiparous) underwent serial cardiometabolic characterization (anthropometry, blood pressure, lipids, oral glucose tolerance test, insulin sensitivity/resistance (Matsuda index, HOMA-IR), C-reactive protein (CRP), adiponectin) at 1-year, 3-years, and 5-years postpartum. Based on the magnitude of weight change between pre-pregnancy and 5-years postpartum, they were stratified into the following 3 groups: weight loss (n = 100), weight gain 0–6% (n = 110), and weight gain ≥ 6% (n = 120). At 1-year postpartum, cardiovascular risk factors did not differ between the groups. However, an adverse risk factor profile progressively emerged in the weight retention groups at 3- and 5-years. Indeed, after covariate adjustment, there was stepwise worsening (from the weight loss group to weight gain 0–6% to weight gain ≥ 6% group) of the following cardiovascular risk factors at 5-years: triglycerides (p = 0.001), HDL (p = 0.02), LDL (p = 0.01), apolipoprotein-B (p = 0.003), Matsuda index (p < 0.0001), HOMA-IR (p < 0.0001), fasting glucose (p = 0.07), and CRP (p = 0.01). Moreover, on logistic regression analyses, weight gain ≥ 6% emerged as an independent predictor of pre-diabetes/diabetes at 5-years (adjusted OR = 3.40, 95%CI: 1.63–7.09). Postpartum weight retention predicts trajectories of worsening cardiovascular risk factors and glucose intolerance over the first 5-years after delivery, consistent with its postulated contribution to future vascular disease in women.

中文翻译：

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产后体重保留和怀孕后 5 年内心血管风险的早期演变

女性一生中每次怀孕造成的产后体重滞留的累积效应可能会增加她最终患上 2 型糖尿病和心血管疾病的风险。然而，支持这一假设的直接证据有限。因此，我们试图描述产后体重保留对怀孕后头 5 年心血管危险因素轨迹的影响。在这项前瞻性观察队列研究中，330 名女性（平均年龄 35.7 ± 4.3 岁，平均孕前体重指数 25.2 ± 4.8 kg/m2，50.9% 为初产妇）接受了一系列心脏代谢特征分析（人体测量、血压、血脂、口服葡萄糖耐量）产后1年、3年、5年的检查、胰岛素敏感性/抵抗（松田指数、HOMA-IR）、C反应蛋白（CRP）、脂联素）。根据孕前和产后 5 年之间体重变化的幅度，将她们分为以下 3 组：体重减轻 (n = 100)、体重增加 0–6% (n = 110) 和体重增加 ≥ 6%（n = 120）。产后一年，两组之间的心血管危险因素没有差异。然而，体重保持组在 3 年和 5 年时逐渐出现不利的危险因素。事实上，经过协变量调整后，5 年时以下心血管危险因素逐步恶化（从体重减轻组到体重增加 0-6% 到体重增加 ≥ 6% 组）：甘油三酯 (p = 0.001)、HDL (p = 0.02)、LDL (p = 0.01)、载脂蛋白-B (p = 0.003)、Matsuda 指数 (p < 0.0001)、HOMA-IR (p < 0.0001)、空腹血糖 (p = 0.07) 和 CRP ( p = 0.01）。此外，在逻辑回归分析中，体重增加 ≥ 6% 成为 5 年糖尿病前期/糖尿病的独立预测因子（调整后 OR = 3.40，95%CI：1.63-7.09）。产后体重滞留预示着产后前 5 年内心血管危险因素和葡萄糖耐受不良恶化的轨迹，这与其对女性未来血管疾病的假定贡献一致。