{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:55:16Z","timestamp":1792173316015,"version":"4.4.0"},"reference-count":52,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,4,16]]},"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the effect of interpregnancy body mass index (BMI) change on pregnancy outcomes, including large-for-gestational-age babies (LGA), small-for-gestational-age babies (SGA), macrosomia, gestational diabetes mellitus (GDM) and caesarean section (CS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis of observational cohort studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>Literature searches were performed across Cochrane, MEDLINE, EMBASE, CINAHL, Global Health and MIDIRS databases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study selection<\/jats:title>\n                    <jats:p>Observational cohort studies with participants parity from 0 to 1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Adjusted ORs (aORs) with 95% CIs were used to evaluate the association between interpregnancy BMI change on five outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      925\u2009065 women with singleton births from parity 0 to 1 were included in the meta-analysis of 11 studies selected from 924 identified studies. A substantial increase in interpregnancy BMI (&gt;3 BMI units) was associated with an increased risk of LGA (aOR 1.85, 95%\u2009CI 1.71 to 2.00, p&lt;0.001), GDM (aOR 2.28, 95% CI 1.97 to 2.63, p&lt;0.001), macrosomia (aOR 1.54, 95%\u2009CI 0.939 to 2.505) and CS (aOR 1.72, 95% CI 1.32 to 2.24, p&lt;0.001) compared with the reference category, and a decreased risk of SGA (aOR 0.83, 95%\u2009CI 0.70 to 0.99, p=0.044). An interpregnancy BMI decrease was associated with a decreased risk of LGA births (aOR 0.70, 95%\u2009CI 0.55 to 0.90, p&lt;0.001) and GDM (aOR 0.80, 95%\u2009CI 0.62 to 1.03), and an increased risk of SGA (aOR 1.31, 95%\u2009CI 1.06 to 1.63, p=0.014). Women with a normal BMI (&lt;25kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) at first pregnancy who have a substantial increase in BMI between pregnancies had a higher risk of LGA (aOR 2.10, 95% CI 1.93 to 2.29) and GDM (aOR 3.10, 95% CI 2.74 to 3.50) when compared with a reference than women with a BMI \u226525 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      at first pregnancy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Gaining weight between pregnancies increases risk of developing GDM, CS and LGA, and reduces risk of SGA in the subsequent pregnancy. Losing weight between pregnancies reduces risk of GDM and LGA and increases risk of SGA. Weight stability between first and second pregnancy is advised in order to reduce risk of adverse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>CRD42016041299.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-018778","type":"journal-article","created":{"date-parts":[[2018,6,4]],"date-time":"2018-06-04T07:05:13Z","timestamp":1528095913000},"page":"e018778","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":66,"title":["Interpregnancy weight change and adverse pregnancy outcomes: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"8","author":[{"suffix":"Dr","given":"Eugene","family":"Oteng-Ntim","sequence":"first","affiliation":[{"name":"London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Mononen","sequence":"additional","affiliation":[{"name":"Department of Women and Children\u2019s Health, King\u2019s College, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Sawicki","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul T","family":"Seed","sequence":"additional","affiliation":[{"name":"Department of Women and Children\u2019s Health, King\u2019s College, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Bick","sequence":"additional","affiliation":[{"name":"Department of Women and Children\u2019s Health, King\u2019s College, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucilla","family":"Poston","sequence":"additional","affiliation":[{"name":"Department of Women and Children\u2019s Health, King\u2019s College, London, UK"},{"name":"Women\u2019s and children, King\u2019s College London, London, England, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,6,4]]},"reference":[{"key":"2025120600260960000_8.6.e018778.1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0061627","article-title":"Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight\/obesity: a systematic review and meta-analysis","volume":"8","author":"Yu","year":"2013","journal-title":"PLoS One"},{"key":"2025120600260960000_8.6.e018778.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.03.027"},{"key":"2025120600260960000_8.6.e018778.3","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1002\/dmrr.2656","article-title":"Trends in the incidence of diabetes, its clinical sequelae, and associated costs in pregnancy","volume":"31","author":"Jovanovi\u010d","year":"2015","journal-title":"Diabetes Metab Res Rev"},{"key":"2025120600260960000_8.6.e018778.4","doi-asserted-by":"publisher","DOI":"10.1080\/14647270701731290"},{"key":"2025120600260960000_8.6.e018778.5","first-page":"170","article-title":"The impact of maternal obesity on maternal and fetal health","volume":"1","author":"Leddy","year":"2008","journal-title":"Rev Obstet Gynecol"},{"key":"2025120600260960000_8.6.e018778.6","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-10-47"},{"key":"2025120600260960000_8.6.e018778.7","first-page":"1","article-title":"Recommendations to improve preconception health and health care--United States. 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