Excess gestational weight gain may result in increased mortality in the long term

1. Among underweight mothers, weight gain in pregnancy above the recommendations was associated with increased cardiovascular mortality.

2. Gestational weight gain in mothers with normal weight was associated with increased all-cause and cardiovascular mortality but not diabetes-related mortality. 

Evidence Rating Level: 2 (Good)

Study Rundown: High pregnancy weight gain is linked to increased postpartum weight retention; however, the long-term effects on overall health are not well understood. The Collaborative Perinatal Project (CPP) investigated the association between gestational weight changes with mortality over 50 years since, until now, limited research has been conducted in this domain. This prospective cohort study aimed to assess the long-term effect of gestational weight change on mortality among postpartum women. The primary outcome was all-cause mortality while key secondary outcomes included cardiovascular disease and diabetes. According to study results, excess gestational weight gain was associated with increased all-cause mortality in a baseline weight-dependent manner. Although this study was well done, the findings were limited by wide confidence intervals, impacting result precision.

Click to read the study in The Lancet

Relevant Reading: Association between Obesity during Pregnancy and Increased Use of Health Care

In-depth [prospective cohort]: 48,197 pregnant people were enrolled at 12 US clinical centers between 1959-1966. Altogether, 46,042 patients were included with 20,839 (45.3%) identifying as Black and 21,287 (46.2%) as White. The primary outcome focused on gestational weight change and its association with all-cause mortality over 50 years, revealing varied impacts based on pre-pregnancy BMI (BMI<18.5 kg/m2: increased cardiovascular mortality (hazard rate [HR] 1.84, 95% confidence interval [CI] 1.08-3.12); BMI 18.5-24.9 kg/m2: increased all-cause mortality (HR 1.09, 95% CI 1.01-1.18) and cardiovascular mortality (HR 1.20, 95% CI 1.04-1.37); and BMI 25.0-29.9 kg/m2: increased all-cause mortality (HR 1.12, 95% CI 1.01-1.24) and diabetes-related mortality (HR 1.77, 95% CI 1.23-2.54)). Overall, findings from this study suggest that maintaining healthy gestational weight gain within recommended levels is crucial, with implications extending to long-term health, including cardiovascular and diabetes-related mortality.

Image: PD

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