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Master Thesis

Inégalités sociales de risque métabolique en population caribéenne : quelle place pour la grossesse dans les stratégies de prévention ?

Abstract : Introduction : In the Caribbean, women are particularly vulnerable to metabolic risk. Obesity and multiparity are associated, especially among the disadvantaged women. Objective : We aim to explore the relationship between postpartum weight retention (PPWR) and socioeconomic factors in the French West Indies. Methods : A longitudinal study was conducted including all women who delivered at the Guadeloupean University Hospital between 2014/12/01 and 2015/08/03, except multiple pregnancies and terms < 22 weeks. Data were collected on hospital records (1167) and phone interviews. Were explored : prepregnancy weight, delivery weight and weight at 18 months postpartum, education and income levels, physical activity and eating behaviors. PPWR was defined by a 18 months postpartum weight > prepregnancy weight. Linear and logistic regression were used, taking into account age, parity, gestational and obstetrical complications, alcohol and tobacco consumption, treatments affecting weight, breastfeeding, contraception.Results:596 women could be contacted at 18 months. PPWR was observed in 64.1% of them. Among the women with low income (non-taxable) vs the women with higher income, BMI at delivery was increased by 3.9 vs 4.1 kg/m² (p=0.296), and BMI at 12 months postpartum was increased by 1.2 vs 0.7 kg/m² (p=0.004). The Odds-Ratio of PPWR was 2.04 (95%CI: 1.39-3.00) in women with low income compared to the women with higher income. This OR decreased when physical inactivity and soda consumption variables were added into the model. Conclusion : In this population, there were social disparities in PPWR potentially mediated by risky behaviors. Postpartum seems to be a critical period for obesity prevention.
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Master Thesis
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Nathalie David, Thibault Musson. Inégalités sociales de risque métabolique en population caribéenne : quelle place pour la grossesse dans les stratégies de prévention ?. Médecine humaine et pathologie. 2017. ⟨dumas-01698063⟩

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