The duration of the interpregnancy interval in multiparous women and maternal weight gain between pregnancies: findings from a UK population-based cohort

Nida Ziauddeen,Nisreen A Alwan,Nicholas S Macklon,Paul J Roderick

doi:10.1038/s41598-019-45595-0

Abstract

Maternal obesity in pregnancy increases the risk of adverse long-term health outcomes in both mother and offspring. A population-based cohort of prospectively collected routine antenatal healthcare data collected between January 2003 and September 2017 at University Hospital Southampton, UK was utilised to investigate the association between duration of interpregnancy interval between successive pregnancies and gain in maternal body mass index by the start of the next pregnancy. Records of 19362 women with two or more consecutive singleton live births were analysed. Two-thirds had gained weight when presenting to antenatal care for their subsequent pregnancy with 20% becoming overweight/obese. Compared to an interval of 24–35 months, an interval of 12–23 months was associated with lowest risk of weight gain (adjusted RR 0.91, 99% CI 0.87 to 0.95, p < 0.001) and ≥36 months with greatest risk (adjusted RR 1.11, 99% CI 1.07 to 1.15, p < 0.001) for the first to second pregnancy. This study shows that most multiparous women start their pregnancy with a higher weight than their previous one. An interval of 12–23 months is associated with the lowest risk of starting the second pregnancy with a higher body weight accounting for age. In countries with high prevalence of maternal obesity, birth spacing may merit exploration as a factor impacting on perinatal morbidity.

Highlights

Pregnancy is a period of metabolic and behavioural changes, the effects of which last beyond the immediate pregnancy for both mother and child[1] affecting subsequent children
Two-thirds of women presenting for antenatal care for a second pregnancy in Ireland an average of 18 months after delivery had gained weight with 20% in a higher compared to 5.8% in a lower body mass index (BMI) category than the first pregnancy[13]
This study examined the association of change in maternal BMI between pregnancies with interpregnancy interval in 19362 women in Hampshire, England

Summary

Introduction

Pregnancy is a period of metabolic and behavioural changes, the effects of which last beyond the immediate pregnancy for both mother and child[1] affecting subsequent children. Overweight and obesity prevalence has been increasing over the last few decades with data from the Health Survey for England 2015 indicating that an average of 52.1% of women aged 16 to 54 years are overweight or obese[4] This rise in obesity in women of childbearing age and its associated effects on maternal and offspring health[3] make maternal weight change between pregnancies an important consideration as this could modify risk of subsequent offspring. Women with excess gestational weight gain who failed to lose pregnancy weight by six months postpartum were at increased risk of subsequent obesity[6]. Short (59 months) intervals between pregnancies has been associated with increased risk of adverse perinatal outcomes[19] such as preterm birth, low birth weight and small-for-gestational age[19,20]. BMI at the start of the previous pregnancy and socioeconomic status were not taken into account

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