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Abstract
The extent of interpregnancy weight change and its association with subsequent pregnancy outcomes among Asians remain unclear. We examined changes 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. Gestational-age-adjusted BMI was determined by standardising to 12 weeks gestation and interpregnancy BMI change was calculated as the difference between both pregnancies. Pregnancy outcomes were analysed using modified Poisson regression models. Of 6264 included women 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 higher risk of low birthweight (adjusted risk ratio [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. Our study strengthens the case for interpregnancy weight management to improve subsequent pregnancy outcomes.
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Details
1 KK Women’s and Children’s Hospital, Department of Reproductive Medicine, Singapore, Singapore (GRID:grid.414963.d) (ISNI:0000 0000 8958 3388); Duke-NUS Medical School, Singapore, Singapore (GRID:grid.428397.3) (ISNI:0000 0004 0385 0924)
2 University of Cambridge, MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK (GRID:grid.5335.0) (ISNI:0000000121885934)
3 National University of Singapore, Faculty of Science, Singapore, Singapore (GRID:grid.4280.e) (ISNI:0000 0001 2180 6431)
4 Nanyang Technological University, Lee Kong Chian School of Medicine, Singapore, Singapore (GRID:grid.59025.3b) (ISNI:0000 0001 2224 0361)
5 Duke-NUS Medical School, Program in Health Services and Systems Research and Center for Quantitative Medicine, Singapore, Singapore (GRID:grid.428397.3) (ISNI:0000 0004 0385 0924); Tampere University, Tampere Center for Child, Adolescent and Maternal Health Research, Tampere, Finland (GRID:grid.502801.e) (ISNI:0000 0001 2314 6254)
6 University of Southampton, Medical Research Council Lifecourse Epidemiology Centre, Southampton, UK (GRID:grid.5491.9) (ISNI:0000 0004 1936 9297); University of Southampton and University Hospital Southampton National Health Service Foundation Trust, National Institute for Health Research Southampton Biomedical Research Centre, Southampton, UK (GRID:grid.5491.9) (ISNI:0000 0004 1936 9297)
7 KK Women’s and Children’s Hospital, Department of Dietetics, Singapore, Singapore (GRID:grid.414963.d) (ISNI:0000 0000 8958 3388)
8 KK Women’s and Children’s Hospital, Department of Paediatrics, Singapore, Singapore (GRID:grid.414963.d) (ISNI:0000 0000 8958 3388); Duke-NUS Medical School, Singapore, Singapore (GRID:grid.428397.3) (ISNI:0000 0004 0385 0924); Nanyang Technological University, Lee Kong Chian School of Medicine, Singapore, Singapore (GRID:grid.59025.3b) (ISNI:0000 0001 2224 0361)
9 KK Women’s and Children’s Hospital, Department of Reproductive Medicine, Singapore, Singapore (GRID:grid.414963.d) (ISNI:0000 0000 8958 3388); Duke-NUS Medical School, Singapore, Singapore (GRID:grid.428397.3) (ISNI:0000 0004 0385 0924); National University of Singapore, Yong Loo Lin School of Medicine, Singapore, Singapore (GRID:grid.4280.e) (ISNI:0000 0001 2180 6431)