Distribution and association of interpregnancy weight change with subsequent pregnancy outcomes in Asian women
Year: 2023
Type: article
Study design: Observational Study
Abstract: The extent of interpregnancy weight change and its association with subsequent pregnancy outcomes among Asians remain unclear. We aimed to examine the change in maternal body mass index (BMI) between the first two deliveries and outcomes in the second delivery. Medical records of women with their first two consecutive deliveries between 2015 and 2020 at KK Women’s and Children’s Hospital, Singapore were retrieved. Analysis was limited to 6264 women with available BMI for both pregnancies, which was standardised to 12 weeks gestation. The difference between gestational-age-adjusted BMI in both pregnancies was calculated as the change in interpregnancy BMI. Main outcomes were low birthweight (<2.5 kg), high birthweight (≥4 kg), small-for-gestational-age, large-for-gestational-age, preterm delivery, gestational diabetes, elective and emergency Caesarean deliveries. The risk ratios (RR) of pregnancy outcomes were estimated using modified Poisson regression models with confounders adjustment. Of 6264 included women (mean [SD] age 28.4 [4.3] years) with a median interpregnancy interval of 1.44 years, 40.7% had a stable BMI change within +1 kg/m2, 10.3% lost >1 kg/m2, 34.3% gained 1-3 kg/m2 and 14.8% gained ≥3 kg/m2. Compared to women with stable BMI change, those with >1 kg/m2 loss had a higher risk of low birthweight (RR 1.36; 95% confidence interval 1.02-1.80), while those with 1-3 kg/m2 gain had higher risks of large-for-gestational-age birth (1.16; 1.03-1.31), gestational diabetes (1.25; 1.06-1.49) and emergency Caesarean delivery (1.16; 1.03-1.31); these risks were higher in those with ≥3 kg/m2 gain. Stratification by BMI revealed that women with BMI <23 kg/m2 and interpregnancy BMI gain had a higher risk of emergency Caesarean delivery, while those with BMI ≥23 kg/m2 and interpregnancy BMI loss had a higher risk of low birthweight. Interpregnancy BMI alternations more than 1 kg/m2 are associated with adverse outcomes in the second pregnancy among Asian women. Our study suggests the importance of returning to pre-pregnancy weight and maintaining a stable interpregnancy BMI, to achieve better subsequent pregnancy outcomes.
Source: Scientific Reports
Institutions: National University of Singapore, KK Women's and Children's Hospital, Duke-NUS Medical School, University of Cambridge, Wellcome/MRC Institute of Metabolic Science, MRC Epidemiology Unit, Nanyang Technological University, Tampere University, University of Tampere, National Health Service, University Hospital Southampton NHS Foundation Trust, University of Southampton, Medical Research Council
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,390
Awards: G103267656, G1321528303, G1418130382, G1659327504, G183778332, G2188486458, G2680691856, G2693923786, G2834708008, G2838213439, G2845401290, G2975136526, G3424013768, NIHR Senior Investigator Award, G3521509650, G365416998, G3772266808, G389277099, G427574963, NIHR Senior Investigator Award, Capacity Building to Improve Early Nutrition and Health in South Africa, G4964355645, G5023485246, G5045453097, G5061114777, G5114893925, G5285226399, G5741042489, G6206044308, G645171559, G6587044744, G6719865625, G6723020440, G71336211, G7212409199, G7348633402, G7388601084, G740803340, G7646392811, G7671148335, G7852524164, G7915200173, G8307928819, G953086832
OpenAlex ID: W4360853486