Complications Linked to Weight Gain Between Pregnancies

Even modest weight gain can increase risk for adverse outcomes in second pregnancy

FRIDAY, Sept. 29 (HealthDay News) -- Gaining weight between a first and second pregnancy is likely to raise a woman's risk for adverse outcomes during the second, according to study findings published in the Sept. 30 issue of The Lancet. The results suggest a causal relationship between obesity and pregnancy complications.

To determine if temporal changes in weight affects the risk for adverse pregnancy outcomes, Eduardo Villamor, M.D., of Harvard School of Public Health in Boston, and Sven Cnattingius, M.D., from the Karolinska Institute in Stockholm, Sweden, measured body mass index (BMI) change and pregnancy complications in a population of 151,025 Swedish women having two pregnancies between 1992 and 2001.

The investigators found that women gaining three or more BMI units between their pregnancies were at increased risk for preeclampsia (adjusted odds ratio, 1.78), gestational hypertension (1.76), gestational diabetes (2.09), Caesarean delivery (1.32), stillbirth (1.63), and large-for-gestational-age birth (1.87). The associations were linear and remained even if BMIs during both pregnancies were within the healthy range.

The findings "should lead to a call for more randomized trials of weight loss interventions before pregnancy, as well as weight loss postpartum," according to a comment by Aaron Caughey, M.D., from the University of California San Francisco. "With the recent sustained increase in obesity, particularly in the developed world, such interventions are likely to affect not only future pregnancy outcomes but also long-term outcomes in women's health."

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