New research from the University of Virginia has found excessive weight gain during pregnancy is more frequent among women in the military - especially women who were active-duty personnel - than in the civilian population.
The research also found the women with pregnancy weight gain above national guidelines were three times more likely to have substantial postpartum weight retention, which can lead to expensive health complications and potentially derail a woman's long-term miliary career.
Rebecca Krukowski, a professor in UVA's Department of Public Health Sciences and the corresponding author of the study, said her team looked at health care information from the Military Health System Data Repository, comparing it to previously documented civilian samples.
It included data on more than 48,000 women who gave birth in 2018 and 2019 when they were beneficiaries of TRICARE, the uniformed services' health care program.
Of those women, 75% had excessive gestational weight gain and 42% had substantial postpartum weight retention. Those conditions are associated with expensive maternal and neonatal complications like pregnancy-related high blood pressure and low birth weight.
Military spouses and other family members were less likely to gain too much weight. Civilian rates were 47.5%. based on data collected in 2012 and 2013.
The study noted, "Active-duty personnel may experience more drastic changes in eating and exercising habits as a response to pregnancy because they are released from fitness test requirements and generally excused from exercise sessions with their units during pregnancy and in the first 12 months post-partum."
The study authors write "the military may consider alternative strategies for weight management, with a particular focus on women" who are either overweight or obese before they get pregnant.
National Guidelines
The researchers compared pregnancy weight gain to the national guidelines from the National Academy of Medicine. Among the academy's recommendations are that women whose body mass index is between 18.5 and 24.9 gain between 25 and 35 pounds during pregnancy. Women who are overweight, with a body mass index of 25 to 29, should aim to restrict weight gain to 15 to 20 pounds. The study characterized weight gain above those amounts as "excessive."
Rebecca Krukowski, a professor in UVA's Department of Public Health Sciences and the corresponding author of the new study. (Photo by Dan Addison, University Communications)
Krukowski said this is "the first study that clearly documents these relationships between overweight and obesity pregnancy weight gain and substantial weight retention in the military, indicating that these are important things to focus on in terms of considering greater emphasis on weight management before, during and after pregnancy."
The Department of Defense is the largest employer in the country, with more than 3 million people.
"Pregnancy-related weight gain above the national guidelines and postpartum weight retention may make it challenging to regain the required fitness levels for active-duty women and for these women to maintain their career in the military," Krukowski noted. "These results emphasize the importance of support for weight management before, during, and after pregnancy for military populations."
Evidence from some of Krukowski's previous work could provide a roadmap. In 2021, she and a team tested a pregnancy weight gain intervention called "Moms Fit 2 Fight" in a sample of 430 military health care participants.
Researchers found the intervention was successful in reducing excessive pregnancy weight gain in nearly 55% of those who received the intervention.
"But 430 participants was just too small to see an effect," she said. "So, programs like this would be one example of what could be implemented in the military health care system to help prevent excessive pregnancy weight gain or postpartum weight retention."
The new study, "Overweight/Obesity, Gestational Weight Gain, Postpartum Weight Retention, and Maternal/Neonatal Complications in the Military," was just published in the journal Obesity, the Obesity Society's flagship journal.
