Due to demographic and lifestyle changes in industrialised countries, women have a higher body mass index (BMI) and show excessive weight gain during pregnancy. Gestational weight gain across continents and ethnicity has been studied in more than one million women. In the USA, Europe and Asia, women gaining excessive weight represent 51%, 51% and 37% respectively.
Excessive weight gain during pregnancy affects a significant number of women who were already overweight or obese before pregnancy. This excess weight gain is associated with an increased risk of birth by caesarean, but also with a risk of excess weight after delivery (post-partum excess weight). To limit this excess weight, it is important for this group of women to follow a healthy lifestyle (nutrition and physical activity).
Only 10% to 15% of women regain their “normal” weight in the post-partum period. The pregnancy-post-partum period is critical because it can significantly affect long-term weight management and predispose women to obesity and chronic diseases. Prepregnancy BMI, gestational weight gain (GWG) and postpartum weight gain are not only nutritional issues but can also be related to activity, genetics and psychological factors faced by women of childbearing age. Post-partum weight gain is likely due to a combination of several factors such as food intake, lack of physical activity, lactation, smoking status, pre-pregnancy BMI, GWG and parity, and is associated with an increased risk of obesity.
A meta-analysis of 17 studies carried out in different countries around the world showed that:
■ There is a direct relationship between excessive GWG and a high risk of post-partum weight gain. ■ Compared to women with adequate GWG, those with excessive GWG had an average of 3.21 kg excess weight post-partum. ■ Over time, excess post-partum kilograms showed a U-shaped trend, i.e., a decrease in the first year (from 4.33 kg at 3 months to 2.11 kg at 1 year) and then an increase in the following years (from 2.11 kg at 1 year to 4.65 kg at 15 years).
In addition to the extra kilos, young mothers may be confronted with other issues:
■ Sagging skin and localised fat in the belly area ■ Water retention in the legs ■ Lower back pain ■ Stress and fatigue ■ Caesarean scar or relaxation of perineum
Although the vast majority of these women take care of their perineum after childbirth by following their 10 specific rehabilitation sessions, they often forget to treat other issues. Several methods can be used to treat the different areas affected by these changes in the silhouette and these clinical signs (non-invasive remodelling, surgery, adapted nutrition and physical activity, drainage, physiotherapy…). In this global approach, treatments with LPG® technologies are particularly recommended.
HUBER 360® Evolution, a unique technology developed by doctors and physiotherapists, mobilises the whole body down to the deepest muscles with a set of postures that will respect the body of the young mother. There are specific exercises to strengthen the perineum as well as the abs, which will consolidate the classic rehabilitation. A playful and progressive training also allows to strengthen all the back and abdominal muscles, to recover flexibility in order to fight against back pain.
Medical endermologie® treatments can also fit perfectly into this global approach. In addition to their aesthetic effects on sagging skin and localised fat, it is possible to intervene early and painlessly on Caesarean scars to reduce possible pain, improve sensitivity to touch and especially to prevent fibrous adhesions. These adhesions continue to be a major concern with potentially serious consequences(3).
The draining and pain-relieving properties of endermologie treatments have been demonstrated and become an asset in this context to treat water retention, relieve leg heaviness or back pain. The young mother can feel safe and listened to because this treatment delivered by a trained physiotherapist and equipped with the latest LPG® technologies is also a moment to calm down and relax. By seeing the results over time, mothers will be motivated to watch what they eat and resume physical activity, which will help them fight weight gain and regain a healthy silhouette.
SOURCES:
1. Goldstein RF et al. Gestational weight gain across continents and ethnicity: systematic review and meta-analysis of maternal and infant outcomes in more than one million women (read here). BMC Med. 2018 Aug 31;16(1):153.
2. Rong K, Yu K, Han X, Szeto IM, Qin X, Wang J, Ning Y, Wang P, Ma D. Pre-pregnancy BMI, gestational weight gain and postpartum weight retention: a meta-analysis of observational studies (read here). Public Health Nutr. 2015 Aug;18(12):2172-82.
3. Awonuga AO. et al. Postoperative adhesion development following cesarean and open intra-abdominal gynecological operations: a review. Reprod Sci. 2011 Dec;18(12):1166-85 (read here). Goldstein RF et al.
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