Rollercoaster weight changes can repeat with second pregnancy, especially among normal-weight women

November 14, 2019

ANN ARBOR--Everyone knows that gaining excess weight during one pregnancy is bad, but clinicians rarely consider weight gains and losses from one pregnancy to the next--especially in normal-weight women.

But researchers from Marquette University and the University of Michigan found that among normal-weight women, fluctuating weight gain and loss in the first pregnancy is often repeated in subsequent pregnancies--and is associated with higher risk of several pregnancy-related complications.

Interestingly, obese women are not as likely to fall into this weight gain-loss cycle as normal-weight peers, the researchers say. Normal weight is defined as having a BMI less than 25.

"Normal-weight women gain more pounds and also lose more after giving birth," said Marianne Weiss, professor emerita of nursing at Marquette. "This cycle perpetuates with each pregnancy, and it's this rollercoaster weight gain and loss --not just what a woman typically weighs--that predicts poor pregnancy outcomes."

"This study says two things," said Olga Yakusheva, associate professor at the U-M School of Nursing and School of Public Health. "First, don't just look at how much a woman weighs at the first prenatal visit; you have to know her recent pattern of weight gain and loss. Second, pregnancy weight counseling and management should be given equally to all women, not just the ones who are very overweight."

The researchers, who examined 24,795 linked birth records from 2006 to 2013, say first-pregnancy weight gain and subsequent weight loss after birth starts this unhealthy rollercoaster--which in turn increases the risk for gestational diabetes, hypertension, cesarean delivery and fetal macrosomia (bigger-than-average baby) in the next pregnancy.

The study showed that compared with obese women, normal-weight women gained about 6.6 pounds (3 kg) more during both pregnancies and lost about 4.4 pounds (2 kg more) between births.

This surprised Yakusheva.

"I thought that if a lot of weight is gained in the first pregnancy and it was all lost before the second pregnancy, then you're no longer at risk," she said. "Something I didn't consider is that you can be normal weight in the first pregnancy, gain a lot of weight and then lose it before the second pregnancy, and still be at a higher risk of gaining a lot of weight and having negative outcomes in the second pregnancy."

This gain-lose-gain cycle and associated poor pregnancy outcomes reflects Yakusheva's own experience with her two children. Despite rigidly following clinical guidelines with her first child, she added 65 pounds to her 112-pound frame. Neither Yakesheva nor her clinicians noticed or addressed it--she's thin, so weight gain wasn't on anyone's radar.

"I remember the nurses telling me, 'Don't worry about your weight gain, you're tiny,'" she said. "Looking back, I don't think that was healthy for me to hear."

Yakusheva lost the weight before her second pregnancy, yet despite her history, clinicians again didn't address weight gain. Rather, she took it upon herself to monitor her weight.

This doesn't mean weight isn't important, but looking only at weight is myopic, the researchers say. What's more important is how a woman has managed her weight gain and loss in previous pregnancies.

"The bottom line is that women and their perinatal care providers need to pay attention to appropriate weight before, during, and after each pregnancy to set the stage for optimal outcomes in the next pregnancy," Weiss said.
In addition to Weiss and Yakusheva, Kandice Kapinos of the RAND Corp. was also an author of the study, which appears online in November in the Journal of Obstetric, Gynecologic & Neonatal Nursing. The NIH National Center for Advancing Translational Sciences supported the research.

Study: Effects of women's weight changes on adverse outcomes in a second pregnancy

Marianne Weiss
Olga Yakusheva Kandice Kapinos

University of Michigan

Related Pregnancy Articles from Brightsurf:

COVID-19 has a prolonged effect for many during pregnancy
Symptoms for pregnant women with COVID-19 can be prolonged, lasting two months or longer for a quarter of the women who participated in a national study led by UC San Francisco and UCLA.

Relaxed through pregnancy
A group of researchers from Charité - Universitätsmedizin Berlin have been able to show that maternal psychological wellbeing during pregnancy has a positive effect on newborn infants.

Trajectories of antidepressant medication use during pregnancy
In an analysis of women who started pregnancy when taking antidepressant medications, investigators identified three trajectories of antidepressant dispensing during pregnancy: more than half stopped their treatment, a quarter maintained their treatment throughout pregnancy, and one-fifth discontinued it for a minimum of three months and then resumed it during the postpartum period.

Are women using e-cigarettes during preconception and/or pregnancy?
A new study of 1,365 racially/ethnically diverse, low-income pregnant women found that 4% reported e-cigarette use.

A better pregnancy test for whales
To determine whale pregnancy, researchers have relied on visual cues or hormone tests of blubber collected via darts, but the results were often inconclusive.

Cannabis use during pregnancy
The large health care system Kaiser Permanente Northern California provides universal screening for prenatal cannabis use in women during pregnancy by self-report and urine toxicology testing.

Questions and answers about cannabis use during pregnancy
A new study shows that women have many medical questions about the use of cannabis both before and during pregnancy, and during the postpartum period while breastfeeding.

The effect of taking antidepressants during pregnancy
Exposure to antidepressants during pregnancy and the first weeks of life can alter sensory processing well into adulthood, according to research in mice recently published in eNeuro.

Is ivermectin safe during pregnancy?
Is it safe to give ivermectin to pregnant women? To answer this question, researchers from the Barcelona Institute for Global Health (ISGlobal), an institution supported by 'la Caixa,' conducted a systematic review and meta-analysis of studies that reported cases of accidental exposure to the drug among pregnant women.

Going to sleep on your back in late pregnancy
This study looked at whether going to sleep on your back in the third trimester of pregnancy was associated with average lower birth weights.

Read More: Pregnancy News and Pregnancy Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to