Is maternal weight gain between pregnancies linked to large-for-gestational age birth risk?

  • Ziauddeen N & al.
  • BMJ Open
  • 9 Jul 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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  • Maternal weight gain ≥1 kg/m2 between first and second pregnancy was associated with the risk for large-for-gestational age (LGA) birth in the second pregnancy.
  • The risk for new LGA was higher with interpregnancy weight gain compared with remaining weight stable.

Why this matters

  • Findings highlight the importance of preventing weight gain between pregnancies to achieve better maternal and offspring outcomes.

Study design

  • Health records of 15,940 women with 2 consecutive singleton pregnancies were evaluated.
  • Primary outcomes: risk for LGA, recurrent LGA, and new LGA births during the second pregnancy.
  • Funding: University of Southampton Primary Care and Population Sciences PhD studentship and others.

Key results

  • Of 15,940 women, 16% 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 vs 13.5% and 15.9% in women who gained 1-3 and ≥3 kg/m2, respectively.
  • The proportion was higher in obese women who gained ≥3 kg/m2 (21.2%).
  • Overweight women who lost ≥1 kg/m2 were at lower risk for recurrent LGA in the second pregnancy (adjusted relative risk (aRR), 0.69; 95% CI, 0.48-0.97), whereas those who gained ≥3 kg/m2 were at increased risk of new LGA in the second pregnancy (aRR, 1.35; 95% CI, 1.05-1.75).
  • Normal weight women who gained 1-3 kg/m2 (aRR, 1.26; 95% CI, 1.06-1.50) and ≥3 kg/m2 (aRR, 1.34; 95% CI, 1.09-1.65) were at increased risk for new LGA in the second pregnancy.


  • Lack of information on potential confounders such as breastfeeding duration and gestational weight gain during pregnancy.