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Epidemiology
Research
Ethnic differences in body mass index trajectories from 18 years to postpartum in a population-based cohort of pregnant women in Norway
  1. Tarja I Kinnunen1,
  2. Kåre R Richardsen2,
  3. Line Sletner3,
  4. Leila Torgersen4,
  5. Christine Sommer5,
  6. Christin W Waage6,
  7. Ibrahimu Mdala7,
  8. Anne Karen Jenum7
  1. 1 Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
  2. 2 Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
  3. 3 Department of Child and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway
  4. 4 Department of Child Development, Norwegian Institute of Public Health, Oslo, Norway
  5. 5 Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
  6. 6 Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway
  7. 7 General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
  1. Correspondence to Dr Anne Karen Jenum; a.k.jenum{at}medisin.uio.no

Abstract

Objectives To explore ethnic differences in changes in body mass index (BMI) from the age of 18 years to 3 months postpartum.

Design A population-based cohort study.

Setting Child Health Clinics in Oslo, Norway.

Participants Participants were 811 pregnant women (mean age 30 years). Ethnicity was categorised into six groups.

Primary outcome measures The outcome variable was BMI (kg/m2) measured at the age of 18 and 25 years, at prepregnancy and at 3 months postpartum. Body weight at 18 years, 25 years and prepregnancy were self-reported in early pregnancy, while body height and weight at 3 months postpartum were measured. The main statistical method was generalised estimating equations, adjusted for age. The analyses were stratified by parity due to ethnicity×time×parity interaction (p<0.001).

Results Primiparous South Asian women had a 1.45 (95% CI 0.39 to 2.52) kg/m² higher and Middle Eastern women had 1.43 (0.16 to 2.70) kg/m2 higher mean BMI increase from 18 years to postpartum than Western European women. Among multiparous women, the mean BMI increased 1.99 (1.02 to 2.95) kg/m2 more in South Asian women, 1.48 (0.31 to 2.64) kg/m2 more in Middle Eastern women and 2.49 (0.55 to 4.42) kg/m2 more in African women than in Western European women from 18 years to prepregnancy. From 18 years to postpartum, the mean increase was 4.40 (2.38 to 6.42) kg/m2 higher in African women and 1.94 to 2.78 kg/m2 higher in the other groups than in Western European women.

Conclusions Multiparous women of ethnic minority origin seem substantially more prone to long-term weight gain than multiparous Western European women in Norway.

  • ethnicity
  • body mass index
  • pregnancy
  • postpartum
  • parity

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-022640

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    Footnotes

    • Contributors TIK, KRR, LS, LT, CS, CWW, IM and AKJ participated in formulating the research question. AKJ and LS designed and carried out the study. TIK, KRR and IM analysed the data. TIK, KRR, LS, LT, CS, CWW, IM and AKJ participated in writing and revising the article and accepted the final version of it.

    • Funding The data collection was supported by the Research Council of Norway, the South-Eastern Norway Regional Health Authority, Norwegian Directorate of Health and collaborative partners in The City of Oslo, Stovner, Grorud and Bjerke administrative districts.

    • Competing interests None declared.

    • Ethics approval The study protocol was approved by the Regional Ethics Committee (2007/894) and the Norwegian Data inspectorate.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The datasets analysed during the current study may be available from the principal investigator (Anne Karen Jenum) on reasonable request.

    • Patient consent for publication Not required.