Unhealthy Weight Linked To Poor Pregnancy Outcomes

Maya Tabet, MS Graduate Research Assistant Saint Louis University College for Public Health and Social Justice Department of Epidemiology St. Louis, MO 63104 MedicalResearch.com Interview with:
Maya Tabet, MS
Graduate Research Assistant
Saint Louis University
College for Public Health and Social Justice
Department of Epidemiology
St. Louis, MO 63104

MedicalResearch: What is the background for this study?

Response: The majority of women in the U.S. have an unhealthy weight before they start pregnancy, most of them being overweight or obese. It is well-known that having an unhealthy weight before pregnancy increases the likelihood of having adverse outcomes for the mother and baby. However, this study is the first to examine the likelihood of adverse outcomes in a second pregnancy among women who had an unhealthy weight before a first pregnancy that had no complications.

MedicalResearch: What are the main findings?

Response: Our study involved 121,049 women in Missouri who delivered their first 2 singleton pregnancies between 1989 and 2005. Findings revealed that women who were underweight before a first uncomplicated pregnancy had a 20% increased likelihood of having a shorter gestation and a 40% increased likelihood of having a small baby for gestational age in the second pregnancy, as compared to women who had a healthy weight before their first pregnancy.

Also, women who were obese before a first uncomplicated pregnancy had a 55% increased likelihood of having a large baby for gestational age, a 156% increased likelihood of having preeclampsia, and an 85% increased likelihood of having a cesarean delivery. Babies born to these women also had a 37% increased likelihood of dying in the first 28 days of their life.

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

Response: Second-time mothers who had an unhealthy weight when they started their first pregnancy have an increased likelihood of poor pregnancy outcomes even when their first pregnancy was uncomplicated. In addition, some of the risk remains even if they reached a normal weight by their second pregnancy.

Health professionals should counsel women of reproductive age on the potential pregnancy complications that an unhealthy weight may engender. Women who had a suboptimal weight before their first pregnancy should be monitored for complications in their subsequent pregnancies even if they had no complications in their first pregnancy or if they reached a healthy weight by their second pregnancy.

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

Response: Our finding that starting pregnancy with an unhealthy weight could pose problems in subsequent pregnancies carries considerable public health implications and is of great clinical significance.

Future research should explore the mechanism by which an unhealthy weight in a first uncomplicated pregnancy may increase the risk of adverse outcomes in a second pregnancy.

Citation:

Am J Obstet Gynecol. 2015 Jun 20. pii: S0002-9378(15)00631-6. doi: 10.1016/j.ajog.2015.06.031.

Prepregnancy body mass index in a first uncomplicated pregnancy and outcomes of a second pregnancy.

Tabet M1, Flick LH2, Tuuli MG3, Macones GA3, Chang JJ2.


Maya Tabet, MS (2015). Unhealthy Weight Linked To Poor Pregnancy Outcomes