Conclusion
This study has shown that a large proportion of women increase their
BMI, and a small proportion decrease their BMI between their first two
pregnancies. Both increase and decrease in BMI between pregnancies were
associated with higher risks of adverse outcomes in the second
pregnancy. These findings highlight the importance of returning to
pre-pregnancy weight and maintaining a stable interpregnancy BMI
thereafter, to achieve better pregnancy outcomes subsequently. However,
the recommended magnitude of weight loss beyond their pre-pregnancy
weight remains unclear, especially for those who are overweight or
obese, where a loss >1 kg/m2 was
associated with SGA and low birthweight. Future studies should examine
the role of interpregnancy lifestyle interventions in maintaining a
stable interpregnancy BMI among Asian women, and more importantly, the
role of metabolic health in adverse pregnancy outcomes with the
measurement of body composition and metabolic biomarkers. This will shed
light on possible aetiologies of low birthweight/SGA and weight loss and
guide personalized interventions and BMI targets for women with lean BMI
and those who are overweight or obese.