Browsing by Subject "Postpartum weight retention"
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Item Development of a risk scale for postpartum weight retention(2003-05) Milani, Tracey Joy; Freeland-Graves, Jeanne H.The purpose of this research was to develop and va lidate a Risk Scale for Postpartum Weight Retention in low-income tri-ethnic women. In Study I, the scale was created in 187 subjects given six questionnaires and monitored for weight from 0 - 6 months postpartum. There were a total of 263 items derived from the questionnaires and 39 were related to weight change at 6 months postpartum (r = -0.20 to 0.61, p < 0.005). Expert review and exploratory multivariate analyses were used to reduce the questionnaire to six items that included weights, fat habits, weight control practices and self-esteem. Weight change was calculated as weight in kilograms retained from prepregnancy to 6 months postpartum. An initial method of evaluation, multiple regression, accounted for 45.8% of the variance in weight change (p < 0.001). A simpler method for clinicians, a ROC curve, discriminated between women who retained < 10 kg prepregnancy weight vs >̲ 10 kg. Area under the curve was 0.87; sensitivity was 76% and specificity, 80%. In Study II, validity was determined in a sample of 75 women who visited health clinics at 1.5 and 6 months postpartum. The risk scale and a demographic questionnaire were administered at 1.5 months postpartum; weight and waist circumference were measured at 1.5 and 6 months after delivering a child. When cross-validated in this sample, multiple regression explained 35.7% of the variance in weight. The ROC curve classified 81% of subjects into correct weight categories, with sensitivity of 65% and specificity, 89%, (p < 0.001). To enhance the predictive ability and reliability of the risk scale, weight at 1.5 months was replaced by waist circumference at 1.5 months postpartum. In the revised scale, multiple regression explained 41.5% of the variance in weight retention (p < 0.001). The updated ROC curve had an area under the curve of 0.83; with a sensitivity and specificity of 65 and 92%, respectively (p < 0.01). These results indicate that the risk scale is a valid measure of postpartum weight retention, using either complex multiple regression or simpler ROC methods. Additionally, waist circumference greatly increases its predictive power in Study II.Item Nutrition knowledge, attitudes, and diet associated with postpartum weight retention in low-income and minority women(2006-05) Nuss, Henry Joseph; Freeland-Graves, Jeanne H.The purpose of this research was to discern associations of nutrition knowledge, attitudes, and diet with postpartum weight retention 1 year following childbirth. Subjects for this research were low-income, Hispanic, non-Hispanic black, and non-Hispanic white women recruited in a hospital 0 -- 1 day postpartum. In study 1, a nutrition attitudes scale was developed and validated in 134 low-income women at 1.5 months post-delivery. The final scale was administered to a second group of 206 women at 1.5, 6 and 12 months postpartum. Attitudes at each time were compared to demographics and weight status. Obese women at 1 year had higher barriers to healthful eating subscale averages than normal and overweight subjects at 1.5 and 6 months, and overweight participants at 12 months. Obese individuals also had greater emotional eating subscale scores than both normal and overweight subjects at 12 months. In study 2, a test of general nutrition knowledge was developed and validated in a sample of 151 women at 1 day post-delivery. The validated instrument was then administered to a test sample of 140 women at 0 and 12 months postpartum. Body weights were measured at 1.5, 6, and 12 months and height 1.5 months. Women with < 5% weight retention at 1 year had greater knowledge at 0 (53% vs.49%, p<0.05) and 12 months (55% vs. 51%, p <0.05) than those with >̲5%. Women who lactated >̲ 6 months had more knowledge than those who lactated < 6 months. In study 3, 182 women visited the research site at 1.5, 3, 6, and 12 months postpartum where dietary data were collected via one 24-hour recall and 2 days of diet records. Weight status was measured during each clinic visit; height was measured at 1.5 months. At 1 year postpartum, obese women had a greater percentage of energy from carbohydrates than their normal weight counterparts (52.5 % vs. 49.6%, p<0.05). Less than half of the population met the recommendations for folate, calcium, magnesium, and vitamins B6, D, E and C at all time points, regardless of ethnicity, BMI and lactation status.