Interpregnancy weight gain and childhood obesity: analysis of a UK population-based cohort

Nida Ziauddeen,Elizabeth Taylor,Jonathan Y Huang,Nisreen A Alwan,Keith M Godfrey,Paul J Roderick

doi:10.1038/s41366-021-00979-z

Abstract

BackgroundMaternal obesity increases the risk of adverse long-term health outcomes in mother and child including childhood obesity. We aimed to investigate the association between interpregnancy weight gain between first and second pregnancies and risk of overweight and obesity in the second child.MethodsWe analysed the healthcare records of 4789 women in Hampshire, UK with their first two singleton live births within a population-based anonymised linked cohort of routine antenatal records (August 2004 and August 2014) with birth/early life data for their children. Measured maternal weight and reported height were recorded at the first antenatal appointment of each pregnancy. Measured child height and weight at 4–5 years were converted to age- and sex-adjusted body mass index (BMI z-score). Log-binomial regression was used to examine the association between maternal interpregnancy weight gain and risk of childhood overweight and obesity in the second child. This was analysed first in the whole sample and then stratified by baseline maternal BMI category.ResultsThe prevalence of overweight/obesity in the second child was 19.1% in women who remained weight stable, compared with 28.3% in women with ≥3 kg/m2 weight gain. Interpregnancy gain of ≥3 kg/m2 was associated with increased risk of childhood overweight/obesity (adjusted relative risk (95% CI) 1.17 (1.02–1.34)), with attenuation on adjusting for birthweight of the second child (1.08 (0.94–1.24)). In women within the normal weight range at first pregnancy, the risks of childhood obesity (≥95th centile) were increased with gains of 1–3 kg/m2 (1.74 (1.07–2.83)) and ≥3 kg/m2 (1.87 (1.18–3.01)).ConclusionChildren of mothers within the normal weight range in their first pregnancy who started their second pregnancy with a considerably higher weight were more likely to have obesity at 4–5 years. Supporting return to pre-pregnancy weight and limiting weight gain between pregnancies may achieve better long-term maternal and offspring outcomes.

Highlights

The prevalence of obesity in women of reproductive age is rising worldwide and is seen in all populations regardless of income status [1]
Weight gained during pregnancy is not always lost after delivery and pregnancy is a risk factor for overweight and obesity in women, which increases with additional pregnancies [6]
1234567890();,: METHODS SLOPE (Studying Lifecourse Obesity PrEdictors) is a population-based anonymised linked cohort of prospectively collected routine maternal antenatal and birth records and child health records for all births registered at University Hospital Southampton (UHS), in the South of England, UK between January 2003 and April 2018

Summary

Introduction

The prevalence of obesity in women of reproductive age is rising worldwide and is seen in all populations regardless of income status [1]. Maternal obesity during pregnancy increases the risk of adverse pregnancy outcomes for both mother and child. Maternal obesity increases the risk of adverse long-term health outcomes in mother and child including childhood obesity. Log-binomial regression was used to examine the association between maternal interpregnancy weight gain and risk of childhood overweight and obesity in the second child. This was analysed first in the whole sample and stratified by baseline maternal BMI category. In women within the normal weight range at first pregnancy, the risks of childhood obesity (≥95th centile) were increased with gains of 1–3 kg/m2 (1.74 (1.07–2.83)) and ≥3 kg/m2 (1.87 (1.18–3.01)).

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