| In developed countries, parity is associated with overweight, while in developing countries, it has mainly been studied in relation to maternal depletion. Because of the increasing prevalence of overweight in developing countries, investigators have begun to study the relationship between parity and overweight in these countries. However, this relationship has not been well investigated across the range of socioeconomic development in low and middle income countries.; We examined whether parity (approximated by number of live births) is associated with overweight (body mass index (BMI)≥25kg/m2) in 50 low and middle income countries using cross-sectional Demographic and Reproductive Health Surveys conducted between 1992 and 2003. We examined how this relationship varied with two measures of country development: wealth and overall development.; Parity was positively associated with overweight in the majority of countries studied. The association was strongest in North Africa/West Asia, where all countries had odds ratios (ORs)>1, with a median OR=1.60 (comparing women with ≥4 children to women with 1 child). The parity-overweight relationship showed weak, positive, significant associations with both country wealth and overall country development.; In the individual-level analysis, the parity-overweight relationship varied with household wealth and country development. Among the poorest women, and women in the 2nd tertile of household wealth, parity was positively related to overweight only in countries at the highest end of development. Among the wealthiest women, parity was positively related to overweight regardless of country development. Results suggest that as development increases, the burden of parity-related overweight shifts to include poor as well as wealthy women.; In the sample of Guatemalan women, we found a strong, positive, significant relationship between number of live births and overweight, comparing women with ≥4 children to women with 1 child, OR=2.44 (95% confidence interval 1.21, 4.92). Recent breastfeeding >24 months was negatively related to overweight compared to 1-12 months, OR=0.44 (0.22, 0.89). The main results did not vary by outcome or by use of summary versus detailed reproductive variables. The consistency of our results lends credibility to the models used in the previous two analyses.; Policy implications of these results might include the development and implementation of programs to prevent excessive gestational weight gain and promote post partum weight loss, via dietary restriction and physical activity, concomitant with exclusive breastfeeding. Our results suggest that in countries at the lowest level of development, these programs should be targeted to wealthy women, whereas in more developed countries such programs should be made available to all women. (Abstract shortened by UMI.)... |
