Introduction
The rates of overweight and obesity continue to increase
worldwide.1 In women, pregnancy is a life stage that
can alter their weight trajectory due to the risk of weight gain during
or between pregnancies.2, 3 Higher parity has been
associated with higher pre-pregnancy body mass index (BMI) and
subsequent development of obesity.4, 5 On average,
women gain approximately 1 kg/m2 of BMI unit between
consecutive pregnancies, with greater interpregnancy weight gain
observed in those with a higher weight before
pregnancy.6
In women who are overweight or obese, or underweight, the risks of
adverse perinatal outcomes are well documented.7, 8However, the extent to which interpregnancy weight change influences the
risks of subsequent maternal and neonatal outcomes remain poorly
understood,9 and most studies have been focused on
Western populations.10 Given that Asians have
increased health risks at different BMI thresholds to
Caucasians,11 and that unique sociocultural factors
may influence weight management behaviours before, during, and after
pregnancy,10 it is essential to personalize weight
management planning for Asian women.
The interpregnancy period represents a unique phase of the reproductive
life-course. A recent systematic review and meta-analysis pooling 61
studies investigating outcomes of interpregnancy weight changes from 11
Western countries highlighted the gaps and clinical
needs.10 Data from this meta-analysis showed that
women with interpregnancy weight gain had increased risks of gestational
diabetes, hypertensive disorders, large-for-gestational-age birth and
caesarean delivery, while those with interpregnancy weight loss had
increased risks for preterm delivery and small-for-gestational-age
birth. In the present study, our aims were to (i) describe the
distribution of weight changes in BMI between first and second
pregnancies among Singaporean women and (ii) examine whether similar
associations between interpregnancy BMI changes and pregnancy outcomes
would be observed in Asian women, compared to those reported in the
aforementioned meta-analysis among Caucasians.10