03 Dec Weight Gain Between Pregnancies Increases Infant Mortality

Prof. Cnattingius

MedicalResearch.com Interview with:
Professor Sven Cnattingius
Professor in reproductive epidemiology
Clinical Epidemiology Unit, Department of Medicine
Karolinska University Hospital
Karolinska Institutet, Stockholm, Sweden 

Medical Research: What is the background for this study?

Prof. Cnattingius: Maternal overweight and obesity are associated with increased risks of stillbirth and infant mortality.

Weight gain between pregnancies increases risks of other obesity-related complications, including preeclampsia, gestational diabetes, and preterm birth. Weight gain appear to increase these risks especially in women who start off with normal weight.

As these complications increases risks of stillbirth and infant mortality, we wanted to study the associations between weight change between successive pregnancies and risks of stillbirth and infant mortality (deaths during the first year of life).

Medical Research: What are the main findings?

Prof. Cnattingius: The main findings include:

• Weight gain increases risk of stillbirth in a dose-response manner.
• In women starting off with normal weight (BMI <25), weight gain  increases risk of infant mortality in a dose-response manner.
• In women starting off with overweight or obesity (BMI >25), weight loss reduces the risk of neonatal mortality (deaths during the first four weeks of life).

Medical Research: What should clinicians and patients take away from your report?

Prof. Cnattingius: After a completed pregnancy, all women (except possibly underweight women) should be encouraged to reduce their weight to the weight they had before pregnancy.

Normal weight women should then be encouraged to keep their weight and overweight/obese women (if possible) to reduce their weight.

Medical Research: What recommendations do you have for future research as a result of this study?

Prof. Cnattingius:

1. More knowledge is needed about the mechanisms by which weight change between pregnancies influence risks of especially stillbirth, but also infant mortality.
2. We also need to know more about whether the weight change between pregnancies is due to weight increase during the first pregnancy and/or weight increase after the first pregnancy.
3. Few women (<5%) in this study lost at least 2 BMI units (corresponding to 5.6 kg) between pregnancies. More knowledge is needed with respect to the possible benefits of weight loss in overweight women.
4. Public health strategies need to be developed with respect to:
   1. Women in childbearing age (how can we reduce weight gain between pregnancies and rates of overweight and obesity among pregnanct women;
   2. B broader perspective – how can we reduce overweight/obesity overall in the society (regardless of gender and sex and society) – this is most likely the most important question.

Citation:

Weight change between successive pregnancies and risks of stillbirth and infant mortality: a nationwide cohort study
 Cnattingius, Sven et al. The Lancet
Published Online: 02 December 2015

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Dr. Sven Cnattingius (2015). Weight Gain Between Pregnancies Increases Infant Mortality 

Last Updated on December 3, 2015 by Marie Benz MD FAAD