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Is maternal weight gain between pregnancies associated with risk of large-for-gestational age birth? Analysis of a UK population-based cohort.

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.

SUBMITTER: Ziauddeen N

PROVIDER: S-EPMC6615839 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Is maternal weight gain between pregnancies associated with risk of large-for-gestational age birth? Analysis of a UK population-based cohort.

Ziauddeen Nida N Wilding Sam S Roderick Paul J PJ Macklon Nicholas S NS Alwan Nisreen A NA

BMJ open 20190709 7

<h4>Objective</h4>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.<h4>Design</h4>Population-based cohort.<h4>Setting</h4>Routinely collected antenatal healthcare data between January 2003 and September 2017 at University Hospital Southampton, England.<h4>Participants</h4>Health reco ...[more]

PMID: 31289065

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Project description:BACKGROUND:Japan has an exceptionally high proportion of low-weight births and underweight women. It has been suggested that an appropriate increase in gestational weight gain (GWG) for underweight women will help to prevent low birth weight. The current strategy aims to raise the desired value of GWG equally for all pregnant women within the underweight category. However, it remains elusive whether or not the relationship between GWG and birth weight for gestational age (BW/GA) are uniformly equivalent for all the women. METHODS:We performed a retrospective cohort analysis of women who delivered their newborns at Tokyo Medical and Dental University Hospital from 2013 to 2017. First, in order to examine the direct effect of an increase or decrease in GWG on BW/GA, we analyzed the correlation between inter-pregnancy differences in GWG and BW/GA using a sub-cohort of women who experienced two deliveries during the study period (n = 75). Second, we dichotomized the main cohort (n = 1114) according to BW/GA to verify our hypothesis that the correlation between GWG and BW/GA differs depending on the size of the newborn. RESULTS:The inter-pregnancy difference in BW/GA was not correlated with that of GWG. However, the correlation between BW/GA of siblings was high (r = 0.63, p = 1.9 × 10- 9). The correlation between GWG and BW/GA in women who delivered larger-sized newborns was higher (r = 0.17, p = 4.1 × 10- 5) than that in women who delivered smaller-sized newborns (r = 0.099, p = 1.9 × 10- 2). This disparity did not change after adjustment for pre-pregnancy BMI. The mean birth weight in the dichotomized groups corresponded to percentile 52.0 and 13.4 of the international newborn size assessed by INTERGROWTH-21st standards. CONCLUSIONS:In our study, GWG was positively correlated with BW/GA for heavier neonates whose birth weights were similar to the average neonatal weight according to world standards. However, caution might be required for low-birth-weight neonates because increased GWG does not always result in increased birth weight.

Dataset Information

Is maternal weight gain between pregnancies associated with risk of large-for-gestational age birth? Analysis of a UK population-based cohort.

Publications

Is maternal weight gain between pregnancies associated with risk of large-for-gestational age birth? Analysis of a UK population-based cohort.

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