An important risk factor for cardiovascular disease is obesity, which is more common in women than men. Pregnancy has frequently been cited as a contributor to overweight in women due to gestational weight gain and postpartum weight retention. Obesity prevalence is rapidly rising in urban women in Suriname. The main objective of this study was to assess whether parity is associated with obesity, as measured by body mass index (BMI).Design and method:
The Healthy Life in Suriname (HELISUR) study randomly selected 1,800 subjects of different ancestries living in Paramaribo. Questionnaires on demographic factors, disease history, use of medication, and women's health were collected. Height, weight, blood pressure and serum glucose and cholesterol were measured. We used multiple linear regression analysis to explore the association between obesity and parity, independent of several covariates.Results:
Of the 1,800 subjects, 1,159 participated in the physical examination, of which 728 were women (309 Asian; 299 African and 120 of mixed/other ancestry). With increasing parity, crude mean BMI raised significantly (Figure 1, panel A), with a more prominent effect in African-Surinamese compared to Asian-Surinamese women (Figure 1, panel B).Results:
In multivariable regression analysis, BMI increased by 0.32 kg/m2 (95% CI 0.07 – 0.56) per child, after adjustment for age, ancestry, educational level, current breastfeeding, menopausal status, use of hormonal contraceptives, fasting serum glucose, serum total cholesterol, and systolic blood pressure. Systolic blood pressure, glucose and cholesterol increased respectively 7.36 (95% CI 5.49 – 9.23) mmHg, 0.49 (95% CI 0.29 – 0.70) and 0.18 (95% CI 0.08 – 0.28) mmol/L with each parity group. However, this association was abolished after adjustment for age.Conclusions:
Our study demonstrated that parity is associated with a higher BMI in urban Surinamese women, even after adjustment for several covariates. The effect of parity seems to be stronger in African-Surinamese women compared to Asian-Surinamese women. The higher BMI was not accompanied by a worse metabolic profile. Preventive programs for pre- and postpartum women should focus on education about their increased risk of developing obesity.