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Abstract
Objective Maternal overweight and obesity during pregnancy increases the risk of large-for-gestational age (LGA) birth and childhood obesity. We aimed to investigate the association between maternal weight change between subsequent pregnancies and risk of having a LGA birth.
Design Population-based cohort.
Setting Routinely collected antenatal healthcare data between January 2003 and September 2017 at University Hospital Southampton, England.
Participants Health records of women with their first two consecutive singleton live-birth pregnancies were analysed (n=15 940).
Primary outcome measure Risk of LGA, recurrent LGA and new LGA births in the second pregnancy.
Results Of the 15 940 women, 16.0% lost and 47.7% gained weight (≥1 kg/m2) between pregnancies. A lower proportion of babies born to women who lost ≥1 kg/m2 (12.4%) and remained weight stable between −1 and 1 kg/m2 (11.9%) between pregnancies were LGA compared with 13.5% and 15.9% in women who gained 1–3 and ≥3 kg/m2, respectively. The highest proportion was in obese women who gained ≥3 kg/m2 (21.2%). Overweight women had a reduced risk of recurrent LGA in the second pregnancy if they lost ≥1 kg/m2 (adjusted relative risk (aRR) 0.69, 95% CI 0.48 to 0.97) whereas overweight women who gained ≥3 kg/m2 were at increased risk of new LGA after having a non-LGA birth in their first pregnancy (aRR 1.35, 95% CI 1.05 to 1.75). Normal-weight women who gained weight were also at increased risk of new LGA in the second pregnancy (aRR 1.26, 95% CI 1.06 to 1.50 with gain of 1–3 kg/m2 and aRR 1.34, 95% CI 1.09 to 1.65 with gain of ≥3 kg/m2).
Conclusions Losing weight after an LGA birth was associated with a reduced LGA risk in the next pregnancy in overweight women, while interpregnancy weight gain was associated with an increased new LGA risk. Preventing weight gain between pregnancies is an important measure to achieve better maternal and offspring outcomes.
- obesity
- pregnancy
- pregnancy outcome
- weight gain
- large-for-gestational age
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Footnotes
Contributors Study design (NZ, PJR, NSM, NAA), data analysis (NZ, SW), acquisition and interpretation of the data (NZ, NAA), drafting of the manuscript (NZ), revising for content (NZ, SW, PJR, NSM, NAA) and approval of final version before submission (NZ, SW, PJR, NSM, NAA).
Funding This work is supported by a University of Southampton Primary Care and Population Sciences PhD studentship (to NZ), and an Academy of Medical Sciences and Wellcome Trust Grant [AMS_HOP001\1060] (to NAA). NAA is also in receipt of research support from the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre.
Competing interests None declared.
Ethics approval Approval was granted by the University of Southampton Faculty of Medicine Ethics Committee (ID 25508) and the Health Research Authority (HRA) approval (IRAS 242031).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Anonymised data are only available upon request from the authors conditional on approval of the appropriate institutional ethics and research governance processes.
Patient consent for publication Not required.