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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

Is maternal weight gain between pregnancies associated with risk of large-for-gestational age birth? Analysis of a UK population-based cohort
Is maternal weight gain between pregnancies associated with risk of large-for-gestational age birth? Analysis of a UK population-based cohort
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.
2044-6055
1-11
Ziauddeen, Nida
3ad67dd8-26ba-498a-af0a-b1174298995b
Wilding, Sam
a026cae1-cc72-49b5-a52b-ec1d931d72e1
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Macklon, Nicholas
7db1f4fc-a9f6-431f-a1f2-297bb8c9fb7e
Alwan, Nisreen
0d37b320-f325-4ed3-ba51-0fe2866d5382
Ziauddeen, Nida
3ad67dd8-26ba-498a-af0a-b1174298995b
Wilding, Sam
a026cae1-cc72-49b5-a52b-ec1d931d72e1
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Macklon, Nicholas
7db1f4fc-a9f6-431f-a1f2-297bb8c9fb7e
Alwan, Nisreen
0d37b320-f325-4ed3-ba51-0fe2866d5382

Ziauddeen, Nida, Wilding, Sam, Roderick, Paul, Macklon, Nicholas and Alwan, Nisreen (2019) Is maternal weight gain between pregnancies associated with risk of large-for-gestational age birth? Analysis of a UK population-based cohort. BMJ Open, 9 (7), 1-11, [e026220]. (doi:10.1136/bmjopen-2018-026220).

Record type: Article

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.

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BMI LGA paper revision 2 v4 clean FINAL 12 6 19 - Accepted Manuscript
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Accepted/In Press date: 12 June 2019
Published date: 9 July 2019

Identifiers

Local EPrints ID: 431821
URI: http://eprints.soton.ac.uk/id/eprint/431821
ISSN: 2044-6055
PURE UUID: 99ae37ea-b6f4-4c24-82a7-14bfbb122ba1
ORCID for Sam Wilding: ORCID iD orcid.org/0000-0003-4184-2821
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850
ORCID for Nisreen Alwan: ORCID iD orcid.org/0000-0002-4134-8463

Catalogue record

Date deposited: 19 Jun 2019 16:30
Last modified: 09 Jan 2022 08:05

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Contributors

Author: Nida Ziauddeen
Author: Sam Wilding ORCID iD
Author: Paul Roderick ORCID iD
Author: Nicholas Macklon
Author: Nisreen Alwan ORCID iD

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