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Childbearing, Stress and Obesity Disparities in Women: A Public Health Perspective

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Abstract

The perinatal period, from early in the first trimester to 1 year postpartum, provides opportunities for novel public health interventions to reduce obesity disparities. We present a unifying socio-biological framework to suggest opportunities for multidisciplinary research and public health approaches to elucidate and target the mechanisms for the development of maternal obesity and related disparities. The framework illustrates the interplay of the social, cultural and physical environment; stress appraisal and response; and coping behaviors on short-term outcomes (e.g. allostatic load and gestational weight gain), the intermediate outcomes of persistent insulin resistance and post-partum weight retention, and longer term outcomes of obesity and its disease consequences. Testing the proposed relationships may provide insights into how childbearing risk factors such as gestational weight gain, postpartum weight retention and parity contribute to obesity, which are needed to inform public health policies and clinical care guidelines aimed at reducing obesity and improving the health of women.

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References

  1. Flegal, K. M., Carroll, M. D., Ogden, C. L., & Curtin, L. R. (2010). Prevalence and trends in obesity among US adults, 1999–2008. JAMA, 303(3), 235–241.

    Article  PubMed  CAS  Google Scholar 

  2. Flegal, K. M., Graubard, B. I., Williamson, D. F., & Gail, M. H. (2005). Excess deaths associated with underweight, overweight, and obesity. JAMA, 293(15), 1861–1867.

    Article  PubMed  CAS  Google Scholar 

  3. Osei-Assibey, G., Kyrou, I., Adi, Y., Kumar, S., & Matyka, K. (2010). Dietary and lifestyle interventions for weight management in adults from minority ethnic/non-White groups: A systematic review. Obesity Reviews, 11, 769–776.

    Article  PubMed  CAS  Google Scholar 

  4. Parra-Medina, D., Wilcox, S., Wilson, D. K., Addy, C. L., Felton, G., & Poston, M. B. (2010). Heart healthy and ethnically relevant (HHER) Lifestyle trial for improving diet and physical activity in underserved African American women. Contemporary Clinical Trials, 31(1), 92–104.

    Article  PubMed  Google Scholar 

  5. Pekmezi, D. W., Neighbors, C. J., Lee, C. S., et al. (2009). A culturally adapted physical activity intervention for Latinas: A randomized controlled trial. American Journal of Preventive Medicine, 37(6), 495–500.

    Article  PubMed  Google Scholar 

  6. Rocha-Goldberg Mdel, P., Corsino, L., Batch, B., et al. (2010). Hypertension Improvement Project (HIP) Latino: Results of a pilot study of lifestyle intervention for lowering blood pressure in Latino adults. Ethnicity & Health, 15(3), 269–282.

    Article  Google Scholar 

  7. Davis, M. P., Rhode, P. C., Dutton, G. R., Redmann, S. M., Ryan, D. H., & Brantley, P. J. (2006). A primary care weight management intervention for low-income African-American women. Obesity (Silver Spring), 14(8), 1412–1420.

    Article  Google Scholar 

  8. Rasmussen, K. M., & Yaktine, A. L. (2009). Commitee to re-examine IOM pregnancy weight guidelines. Institue of Medicine, National Research Council. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press.

  9. Catalano, P. M., Kirwan, J. P., Haugel-de Mouzon, S., & King, J. (2003). Gestational diabetes and insulin resistance: Role in short- and long-term implications for mother and fetus. Journal of Nutrition, 133(5 Suppl 2), 1674S–1683S.

    PubMed  CAS  Google Scholar 

  10. Siega-Riz, A. M., Viswanathan, M., Moos, M. K., et al. (2009). A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: Birthweight, fetal growth, and postpartum weight retention. American Journal of Obstetrics and Gynecology, 201(4), 339.e1–339.e14.

    Article  Google Scholar 

  11. Dietz, P. M., Callaghan, W. M., Morrow, B., & Cogswell, M. E. (2005). Population-based assessment of the risk of primary cesarean delivery due to excess prepregnancy weight among nulliparous women delivering term infants. Maternal and Child Health Journal, 9(3), 237–244.

    Article  PubMed  Google Scholar 

  12. Viswanathan, M., Siega-Riz, A. M., Moos, M. K., Deierlein, A., Mumford, S., Knaack, J., Thieda, P., Lux, L. J., & Lohr, K. N. (2008). Outcomes of maternal weight gain, evidence report/technology assessment no. 168. In: Prepared by RTI International-University of North Carolina Evidence-based Practice Center under contract no. 290-02-0016, ed: Agency for Healthcare Research and Quality Publication NO. 08-E-09. Rockville, MD; May 2008.

  13. Hilson, J. A., Rasmussen, K. M., & Kjolhede, C. L. (2006). Excessive weight gain during pregnancy is associated with earlier termination of breast-feeding among White women. Journal of Nutrition, 136(1), 140–146.

    PubMed  CAS  Google Scholar 

  14. Flegal, K. M., Williamson, D. F., & Graubard, B. I. (2003). Obesity and cancer. New England Journal of Medicine, 349(5), 502–504. (author reply 502–504).

    Article  PubMed  Google Scholar 

  15. Gunderson, E. P., Jacobs, D. R., Jr., Chiang, V., et al. (2009). Childbearing is associated with higher incidence of the metabolic syndrome among women of reproductive age controlling for measurements before pregnancy: The CARDIA study. American Journal of Obstetrics and Gynecology, 201(2), 177 e1–177 e9.

    Article  Google Scholar 

  16. Ogden, C. L., Carroll, M. D., Curtin, L. R., McDowell, M. A., Tabak, C. J., & Flegal, K. M. (2006). Prevalence of overweight and obesity in the United States, 1999–2004. JAMA, 295(13), 1549–1555.

    Article  PubMed  CAS  Google Scholar 

  17. Gordon-Larsen, P., Adair, L. S., Nelson, M. C., & Popkin, B. M. (2004). Five-year obesity incidence in the transition period between adolescence and adulthood: The National Longitudinal Study of Adolescent Health. American Journal of Clinical Nutrition, 80(3), 569–575.

    PubMed  CAS  Google Scholar 

  18. Ogden, C. L., Carroll, M. D., Curtin, L. R., Lamb, M. M., & Flegal, K. M. (2010). Prevalence of high body mass index in US children and adolescents, 2007–2008. JAMA, 303(3), 242–249.

    Article  PubMed  CAS  Google Scholar 

  19. Singh, G. K., Siahpush, M., Hiatt, R. A., & Timsina, L. R. (2010). Dramatic increases in obesity and overweight prevalence and body mass index among ethnic-immigrant and social class groups in the United States, 1976–2008. Journal of Community Health. doi:10.1007/s10900-010-9287-9.

  20. Davis, E. M., Zyzanski, S. J., Olson, C. M., Stange, K. C., & Horwitz, R. I. (2009). Racial, ethnic, and socioeconomic differences in the incidence of obesity related to childbirth. American Journal of Public Health, 99(2), 294–299.

    Article  PubMed  Google Scholar 

  21. Linne, Y., Barkeling, B., & Rossner, S. (2002). Long-term weight development after pregnancy. Obesity Reviews, 3(2), 75–83.

    Article  PubMed  CAS  Google Scholar 

  22. Olson, C. M., Strawderman, M. S., Hinton, P. S., & Pearson, T. A. (2003). Gestational weight gain and postpartum behaviors associated with weight change from early pregnancy to 1 y postpartum. International Journal of Obesity and Related Metabolic Disorders, 27(1), 117–127.

    Article  PubMed  CAS  Google Scholar 

  23. Rooney, B. L., & Schauberger, C. W. (2002). Excess pregnancy weight gain and long-term obesity: One decade later. Obstetrics and Gynecology, 100(2), 245–252.

    Article  PubMed  Google Scholar 

  24. Gunderson, E. P. (2009). Childbearing and obesity in women: Weight before, during, and after pregnancy. Obstetrics and Gynecology Clinics of North America, 36(2):317–332, ix.

    Google Scholar 

  25. Center for Disease Control and Prevention. (2006). Pediatric and pregnancy nutrition surveillence system. Pregnancy Data Tables. Available: http://www.cdc.gov/pednss/pnss_tables/tables_numeric.htm. Accessed Nov 7, 2009.

  26. Caulfield, L. E., Witter, F. R., & Stoltzfus, R. J. (1996). Determinants of gestational weight gain outside the recommended ranges among black and white women. Obstetrics and Gynecology, 87(5 Pt 1), 760–766.

    Article  PubMed  CAS  Google Scholar 

  27. Greene, G. W., Smiciklas-Wright, H., Scholl, T. O., & Karp, R. J. (1988). Postpartum weight change: How much of the weight gained in pregnancy will be lost after delivery? Obstetrics and Gynecology, 71(5), 701–707.

    PubMed  CAS  Google Scholar 

  28. Gunderson, E. P., & Abrams, B. (2000). Epidemiology of gestational weight gain and body weight changes after pregnancy. Epidemiologic Reviews, 22(2), 261–274.

    PubMed  CAS  Google Scholar 

  29. Keppel, K. G., & Taffel, S. M. (1993). Pregnancy-related weight gain and retention: Implications of the 1990 Institute of Medicine guidelines. American Journal of Public Health, 83(8), 1100–1103.

    Article  PubMed  CAS  Google Scholar 

  30. Gunderson, E. P., Abrams, B., & Selvin, S. (2000). The relative importance of gestational gain and maternal characteristics associated with the risk of becoming overweight after pregnancy. International Journal of Obesity and Related Metabolic Disorders, 24(12), 1660–1668.

    Article  PubMed  CAS  Google Scholar 

  31. Lederman, S. A., Alfasi, G., & Deckelbaum, R. J. (2002). Pregnancy-associated obesity in black women in New York City. Maternal and Child Health Journal, 6(1), 37–42.

    Article  PubMed  Google Scholar 

  32. Obel, C., Hedegaard, M., Henriksen, T. B., Secher, N. J., Olsen, J., & Levine, S. (2005). Stress and salivary cortisol during pregnancy. Psychoneuroendocrinology, 30(7), 647–656.

    Article  PubMed  CAS  Google Scholar 

  33. Davis, E. P., Glynn, L. M., Waffarn, F., & Sandman, C. A. (2010). Prenatal maternal stress programs infant stress regulation. Journal of Child of Psychology and Psychiatry. doi:10.1111/j.1469-7610.2010.02314.x.

  34. Davis, E. P., & Sandman, C. A. (2010). The timing of prenatal exposure to maternal cortisol and psychosocial stress is associated with human infant cognitive development. Child Development, 81(1), 131–148.

    Article  PubMed  Google Scholar 

  35. Crandon, A. J. (1979). Maternal anxiety and neonatal wellbeing. Journal of Psychosomatic Research, 23(2), 113–115.

    Article  PubMed  CAS  Google Scholar 

  36. Huizink, A. C., de Medina, P. G., Mulder, E. J., Visser, G. H., & Buitelaar, J. K. (2002). Psychological measures of prenatal stress as predictors of infant temperament. Journal of the American Academy of Child and Adolescent Psychiatry, 41(9), 1078–1085.

    Article  PubMed  Google Scholar 

  37. Huizink, A. C., Robles de Medina, P. G., Mulder, E. J., Visser, G. H., & Buitelaar, J. K. (2003). Stress during pregnancy is associated with developmental outcome in infancy. Journal of Child Psychology and Psychiatry, 44(6), 810–818.

    Article  PubMed  Google Scholar 

  38. Tu, M. T., Lupien, S. J., & Walker, C. D. (2005). Measuring stress responses in postpartum mothers: Perspectives from studies in human and animal populations. Stress, 8(1), 19–34.

    Article  PubMed  CAS  Google Scholar 

  39. Hagan, M. M., Chandler, P. C., Wauford, P. K., Rybak, R. J., & Oswald, K. D. (2003). The role of palatable food and hunger as trigger factors in an animal model of stress induced binge eating. The International Journal of Eating Disorders, 34(2), 183–197.

    Article  PubMed  Google Scholar 

  40. Peters, A., Schweiger, U., Pellerin, L., et al. (2004). The selfish brain: Competition for energy resources. Neuroscience and Biobehavioral Reviews, 28(2), 143–180.

    Article  PubMed  CAS  Google Scholar 

  41. Torres, S. J., & Nowson, C. A. (2007). Relationship between stress, eating behavior, and obesity. Nutrition, 23(11–12), 887–894.

    Article  PubMed  Google Scholar 

  42. Bjorntorp, P., & Rosmond, R. (2000). Obesity and cortisol. Nutrition, 16(10), 924–936.

    Article  PubMed  CAS  Google Scholar 

  43. Rosmond, R., Dallman, M. F., & Bjorntorp, P. (1998). Stress-related cortisol secretion in men: Relationships with abdominal obesity and endocrine, metabolic and hemodynamic abnormalities. Journal of Clinical Endocrinology and Metabolism, 83(6), 1853–1859.

    Article  PubMed  CAS  Google Scholar 

  44. McEwen, B., & Lasley, E. (2002). The end of stress as we know it. Washington DC: John Henry Press.

    Google Scholar 

  45. Epel, E. S., McEwen, B., Seeman, T., et al. (2000). Stress and body shape: Stress-induced cortisol secretion is consistently greater among women with central fat. Psychosomatic Medicine, 62(5), 623–632.

    PubMed  CAS  Google Scholar 

  46. Tull, E. S., Sheu, Y. T., Butler, C., & Cornelious, K. (2005). Relationships between perceived stress, coping behavior and cortisol secretion in women with high and low levels of internalized racism. Journal of the National Medical Association, 97(2), 206–212.

    PubMed  Google Scholar 

  47. Giscombe, C. L., & Lobel, M. (2005). Explaining disproportionately high rates of adverse birth outcomes among African Americans: The impact of stress, racism, and related factors in pregnancy. Psychological Bulletin, 131(5), 662–683.

    Article  PubMed  Google Scholar 

  48. Institute of Medicine. (2010). Bridging the evidence gap in obesity prevention: A framework to inform decision making. Washington, DC: National Academies Press.

    Google Scholar 

  49. Becker, M. H., Maiman, L. A., Kirscht, J. P., Haefner, D. P., & Drachman, R. H. (1977). The Health Belief Model and prediction of dietary compliance: A field experiment. Journal of Health and Social Behavior, 18(4), 348–366.

    Article  PubMed  CAS  Google Scholar 

  50. Geronimus, A. T. (1996). Black/white differences in the relationship of maternal age to birthweight: A population-based test of the weathering hypothesis. Social Science and Medicine, 42(4), 589–597.

    Article  PubMed  CAS  Google Scholar 

  51. Neel, J. V. (1999). Diabetes mellitus: A “thrifty” genotype rendered detrimental by “progress”? 1962. Bull World Health Organ, 77(8), 694–703. discussion 692-693.

    PubMed  CAS  Google Scholar 

  52. Scott, R., & Howard, A. (1970). Models of stress. Chicago: Aldine Publishing Company.

    Google Scholar 

  53. Wolfe, W. A. (2000). Obesity and the African-American woman: A cultural tolerance of fatness or other neglected factors. Ethn Dis. Autumn, 10(3), 446–453.

    CAS  Google Scholar 

  54. Loos, R. J., & Bouchard, C. (2003). Obesity—is it a genetic disorder? Journal of Internal Medicine, 254(5), 401–425.

    Article  PubMed  CAS  Google Scholar 

  55. de Castro, J. M., & Plunkett, S. (2002). A general model of intake regulation. Neuroscience and Biobehavioral Reviews, 26(5), 581–595.

    Article  PubMed  Google Scholar 

  56. Cole, S. A., Butte, N. F., Voruganti, V. S., et al. (2010). Evidence that multiple genetic variants of MC4R play a functional role in the regulation of energy expenditure and appetite in Hispanic children. American Journal of Clinical Nutrition, 91(1), 191–199.

    Article  PubMed  CAS  Google Scholar 

  57. Fawcett, K. A., & Barroso, I. (2010). The genetics of obesity: FTO leads the way. Trends in Genetics, 26(6), 266–274.

    Article  PubMed  CAS  Google Scholar 

  58. Friedlander, Y., Li, G., Fornage, M., et al. (2010). Candidate molecular pathway genes related to appetite regulatory neural network, adipocyte homeostasis and obesity: Results from the CARDIA Study. Annals of Human Genetics, 74(5), 387–398.

    Article  PubMed  CAS  Google Scholar 

  59. van Jaarsveld, C. H., Johnson, L., Llewellyn, C., & Wardle, J. (2010). Gemini: A UK twin birth cohort with a focus on early childhood weight trajectories, appetite and the family environment. Twin Research and Human Genetics, 13(1), 72–78.

    Article  PubMed  Google Scholar 

  60. Hinney, A., Vogel, C. I., & Hebebrand, J. (2010). From monogenic to polygenic obesity: Recent advances. European Child and Adolescent Psychiatry, 19(3), 297–310.

    Article  PubMed  Google Scholar 

  61. Dishy, V., Gupta, S., Landau, R., et al. (2003). G-protein beta(3) subunit 825 C/T polymorphism is associated with weight gain during pregnancy. Pharmacogenetics, 13(4), 241–242.

    Article  PubMed  CAS  Google Scholar 

  62. Drews, K., Seremak-Mrozikiewicz, A., Nowocien, G., Bogacz, A., Kurzawinska, G., & Kaluba-Skotarczak, A. (2007). The insertion/deletion polymorphism (I/D) of the ACE gene in pregnant women with excessive weight gain. Ginekologia Polska, 78(7), 539–543.

    PubMed  Google Scholar 

  63. Gutersohn, A., Naber, C., Muller, N., Erbel, R., & Siffert, W. (2000). G protein beta3 subunit 825 TT genotype and post-pregnancy weight retention. Lancet, 355(9211), 1240–1241.

    Article  PubMed  CAS  Google Scholar 

  64. Burchard, E. G., Ziv, E., Coyle, N., et al. (2003). The importance of race and ethnic background in biomedical research and clinical practice. New England Journal of Medicine, 348(12), 1170–1175.

    Article  PubMed  Google Scholar 

  65. Institute of Medicine. (2003). Unequal treatment: Confronting racial and ethnic disparities in healthcare. In: National academy of sciences (pp. 1–764), ed: The National Academies Press.

  66. Kwate, N. O., Valdimarsdottir, H. B., Guevarra, J. S., & Bovbjerg, D. H. (2003). Experiences of racist events are associated with negative health consequences for African American women. Journal of the National Medical Association, 95(6), 450–460.

    PubMed  Google Scholar 

  67. Sellers, R. M., Caldwell, C. H., Schmeelk-Cone, K. H., & Zimmerman, M. A. (2003). Racial identity, racial discrimination, perceived stress, and psychological distress among African American young adults. Journal of Health and Social Behavior, 44(3), 302–317.

    Article  PubMed  Google Scholar 

  68. Griffith, D. M., Johnson, J., Ellis, K. R., & Schulz, A. J. (2010). Cultural context and a critical approach to eliminating health disparities. Ethnicity and Disease, 20(1), 71–76.

    PubMed  Google Scholar 

  69. Krieger, N. (1990). Racial and gender discrimination: Risk factors for high blood pressure? Social Science and Medicine, 30(12), 1273–1281.

    Article  PubMed  CAS  Google Scholar 

  70. Walcott-McQuigg, J. A. (1995). The relationship between stress and weight-control behavior in African- American women. Journal of the National Medical Association, 87(6), 427–432.

    PubMed  CAS  Google Scholar 

  71. Sanchez-Birkhead, A. C., Kennedy, H. P., Callister, L. C., & Miyamoto, T. P. (2010). Navigating a new health culture: Experiences of immigrant hispanic women. Journal of Immigrant and Minority Health. doi:10.1007/s10903-010-9369-x.

  72. Davis, E. M., Clark, J. M., Carrese, J., Gary, T., & Cooper, L. (2005). Racial and socioecnomic differences in obese women’s weight loss method experiences. American Journal of Public Health, 95(9), 1539–1543.

    Article  PubMed  Google Scholar 

  73. Davis, E. M., Rovi, S., & Johnson, M. S. (2005). Mental Health, Family Function and Obesity in African-American Women. Journal of the National Medical Association, 97(4), 478–482.

    PubMed  Google Scholar 

  74. Bynum, M. S., Burton, E. T., & Best, C. (2007). Racism experiences and psychological functioning in African American college freshmen: Is racial socialization a buffer? Cultural Diversity & Ethnic minority Psychology, 13(1), 64–71.

    Article  Google Scholar 

  75. Gilbert, G. H., Litaker, M. S., & Makhija, S. K. (2007). Differences in quality between dental practices associated with race and income mix of patients. Journal of Health Care for the Poor and Underserved, 18(4), 847–867.

    PubMed  Google Scholar 

  76. Sudano, J. J., & Baker, D. W. (2006). Explaining US racial/ethnic disparities in health declines and mortality in late middle age: The roles of socioeconomic status, health behaviors, and health insurance. Social Science and Medicine, 62(4), 909–922.

    Article  PubMed  Google Scholar 

  77. Elfenbein, D. S., & Felice, M. E. (2003). Adolescent pregnancy. Pediatric Clinics of North America 50(4):781–800, viii.

  78. Resnik, D. B., & Roman, G. (2007). Health, justice, and the environment. Bioethics, 21(4), 230–241.

    Article  PubMed  Google Scholar 

  79. McEwen, B. S., & Wingfield, J. C. (2003). The concept of allostasis in biology and biomedicine. Hormones and Behavior, 43(1), 2–15.

    Article  PubMed  Google Scholar 

  80. Folkman, S., Lazarus, R. S., Dunkel-Schetter, C., DeLongis, A., & Gruen, R. J. (1986). Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50(5), 992–1003.

    Article  PubMed  CAS  Google Scholar 

  81. McEwen, B. S. (1998). Stress, adaptation, and disease. Allostasis and allostatic load. Annals of the New York Academy of Sciences, 840, 33–44.

    Article  PubMed  CAS  Google Scholar 

  82. Rosmond, R. (2005). Role of stress in the pathogenesis of the metabolic syndrome. Psychoneuroendocrinology, 30(1), 1–10.

    Article  PubMed  CAS  Google Scholar 

  83. Selye, H. (1956). The stress of life. New York: McGraw-Hill Companies, Inc. (revised ed).

    Google Scholar 

  84. McEwen, B. S., & Seeman, T. (1999). Protective and damaging effects of mediators of stress. Elaborating and testing the concepts of allostasis and allostatic load. Annals of the New York Academy of Sciences, 896, 30–47.

    Article  PubMed  CAS  Google Scholar 

  85. Institute of Medicine. (1990). Nutrition during pregnancy. Washington DC: National Academy Press.

    Google Scholar 

  86. Harris, H. E., Ellison, G. T., Holliday, M., & Lucassen, E. (1997). The impact of pregnancy on the long-term weight gain of primiparous women in England. International Journal of Obesity and Related Metabolic Disorders, 21(9), 747–755.

    Article  PubMed  CAS  Google Scholar 

  87. Rookus, M. A., Rokebrand, P., Burema, J., & Deurenberg, P. (1987). The effect of pregnancy on the body mass index 9 months postpartum in 49 women. International journal of obesity, 11(6), 609–618.

    PubMed  CAS  Google Scholar 

  88. Williamson, D. F., Madans, J., Pamuk, E., Flegal, K. M., Kendrick, J. S., & Serdula, M. K. (1994). A prospective study of childbearing and 10-year weight gain in US white women 25 to 45 years of age. International Journal of Obesity and Related Metabolic Disorders, 18(8), 561–569.

    PubMed  CAS  Google Scholar 

  89. Olson, C. M., Strawderman, M. S., & Reed, R. G. (2004). Efficacy of an intervention to prevent excessive gestational weight gain. American Journal of Obstetrics and Gynecology, 191(2), 530–536.

    Article  PubMed  Google Scholar 

  90. WHO. (1997). Obesity: Preventing and managing the global epidemic. Report of a WHO consultation of obesity. 1997 June 3–5.

  91. Ryan, E. A. (2003). Hormones and insulin resistance during pregnancy. Lancet, 362(9398), 1777–1778.

    Article  PubMed  Google Scholar 

  92. Scholl, T. O., & Chen, X. (2002). Insulin and the “thrifty” woman: The influence of insulin during pregnancy on gestational weight gain and postpartum weight retention. Maternal and Child Health Journal, 6(4), 255–261.

    Article  PubMed  Google Scholar 

  93. Neel, J. V., Weder, A. B., & Julius, S. (1998). Type II diabetes, essential hypertension, and obesity as “syndromes of impaired genetic homeostasis”: the “thrifty genotype” hypothesis enters the 21st century. Perspectives in Biology and Medicine Autumn, 42(1), 44–74.

    CAS  Google Scholar 

  94. Bechtel-Blackwell, D. A. (2002). Computer-assisted self-interview and nutrition education in pregnant teens. Clinical Nursing Research, 11(4), 450–462.

    Article  PubMed  Google Scholar 

  95. Kinnunen, T. I., Pasanen, M., Aittasalo, M., Fogelholm, M., Weiderpass, E., & Luoto, R. (2007). Reducing postpartum weight retention–a pilot trial in primary health care. Nutrition Journal, 6, 21.

    Article  PubMed  Google Scholar 

  96. Leermakers, E. A., Anglin, K., & Wing, R. R. (1998). Reducing postpartum weight retention through a correspondence intervention. International Journal of Obesity and Related Metabolic Disorders, 22(11), 1103–1109.

    Article  PubMed  CAS  Google Scholar 

  97. O’Toole, M. L., Sawicki, M. A., & Artal, R. (2003). Structured diet and physical activity prevent postpartum weight retention. J Womens Health (Larchmt), 12(10), 991–998.

    Article  Google Scholar 

  98. Ostbye, T., Krause, K. M., Lovelady, C. A., et al. (2009). Active Mothers Postpartum: A randomized controlled weight-loss intervention trial. American Journal of Preventive Medicine, 37(3), 173–180.

    Article  PubMed  Google Scholar 

  99. Hays, R. D., Revicki, D., & Coyne, K. S. (2005). Application of structural equation modeling to health outcomes research. Evaluation & The Health Professions, 28(3), 295–309.

    Article  Google Scholar 

  100. Hoyle, R. H. (1994). Introduction to the special section: Structural equation modeling in clinical research. Journal of Consulting and Clinical Psychology, 62(3), 427–428.

    Article  PubMed  CAS  Google Scholar 

  101. Leermakers, E. A., Anglin, K., & Wing, R. R. (1998). Reducing postpartum weight retention through a correspondence intervention. International Journal of Obesity and Related Metabolic Disorders, 22(11), 1103–1109.

    Article  PubMed  CAS  Google Scholar 

  102. Polley, B. A., Wing, R. R., & Sims, C. J. (2002). Randomized controlled trial to prevent excessive weight gain in pregnant women. International Journal of Obesity and Related Metabolic Disorders, 26(11), 1494–1502.

    Article  PubMed  CAS  Google Scholar 

  103. Crowell, D. T. (1995). Weight change in the postpartum period. A review of the literature. Journal of Nurse-Midwifery, 40(5), 418–423.

    Article  PubMed  CAS  Google Scholar 

  104. National Research Council and Institute of Medicine. (2007). Influence of Pregnancy Weight on Maternal and Child Health. Workshop Report. National Academies Press.

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Acknowledgments

This research was supported by an NIH 5 R25 CA9-355 grant from the National Cancer Institute and Harold Amos Medical Faculty Award from Robert Wood Johnson Foundation, by a Family Medicine Research Center grant from the American Academy of Family Physicians and by a Clinical Research Professorship from the American Cancer Society.

Conflict of Interests

There are no financial or conflicts of interests for any of the authors.

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Authors and Affiliations

  1. Department of Medicine, University of Pittsburgh, 230 McKee Pl, Suite 600, Pittsburgh, PA, 15213, USA

    Esa M. Davis

  2. Department of Family Medicine, Case Western Reserve University, Cleveland, OH, USA

    Esa M. Davis & Kurt C. Stange

  3. Department of Epidemiology & Biostatistics, Case Western Reserve University, Cleveland, OH, USA

    Kurt C. Stange

  4. Department of Sociology, Case Western Reserve University, Cleveland, OH, USA

    Kurt C. Stange

  5. Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA

    Kurt C. Stange

  6. Department of Medicine, Stanford University, Palo Alto, CA, USA

    Ralph I. Horwitz

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Correspondence to Esa M. Davis.

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Davis, E.M., Stange, K.C. & Horwitz, R.I. Childbearing, Stress and Obesity Disparities in Women: A Public Health Perspective. Matern Child Health J 16, 109–118 (2012). https://doi.org/10.1007/s10995-010-0712-6

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  • DOI: https://doi.org/10.1007/s10995-010-0712-6

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