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Interpregnancy Weight Gain and Risks of Perinatal Death: A Systematic Review and Meta-Analysis.

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Excessive interpregnancy weight gain (IPWG) significantly elevates the risk of perinatal death, stillbirth, and neonatal death. This highlights the critical need for weight management counseling between pregnancies to improve maternal and infant outcomes.

Keywords:
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Area of Science:

  • Reproductive Health
  • Perinatal Medicine
  • Epidemiology

Background:

  • The association between interpregnancy weight gain (IPWG) and perinatal mortality requires further clarification.
  • Understanding this link is crucial for optimizing maternal and infant health outcomes between pregnancies.

Purpose of the Study:

  • To conduct a meta-analysis examining the impact of interpregnancy body mass index (BMI) increase on perinatal mortality.
  • To quantify the risk of perinatal death, stillbirth, and neonatal death associated with IPWG.

Main Methods:

  • A systematic search of MEDLINE, Embase, Cochrane Library, and Web of Science was performed in July 2024.
  • Included observational studies reporting IPWG (≥2 BMI units or category change) and perinatal mortality.
  • Random effects meta-analyses were used to pool adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
  • Risk of bias was assessed using the ROBINS-I tool.

Main Results:

  • The meta-analysis included 10 studies encompassing 3,072,698 pregnancies.
  • Interpregnancy weight gain (IPWG) was significantly associated with increased risk of perinatal death (aOR, 1.49; 95% CI, 1.32-1.69).
  • IPWG also increased the risk of stillbirth (aOR, 1.46; 95% CI, 1.23-1.72) and neonatal death (aOR, 1.39; 95% CI, 1.19-1.61).

Conclusions:

  • Interpregnancy weight gain (IPWG) is a significant risk factor for adverse perinatal outcomes, including perinatal death, stillbirth, and neonatal death.
  • These findings underscore the importance of weight management counseling during the interpregnancy period to mitigate risks.
  • Further research may explore interventions to promote healthy interpregnancy weight trajectories.