Skip to main content

Short Inter-pregnancy Intervals, Parity, Excessive Pregnancy Weight Gain and Risk of Maternal Obesity

Maternal and Child Health Journal volume 18, pages 554–562 (2014)Cite this article

Abstract

To investigate the relationship among parity, length of the inter-pregnancy intervals and excessive pregnancy weight gain in the first pregnancy and the risk of obesity. Using a prospective cohort study of 3,422 non-obese, non-pregnant US women aged 14–22 years at baseline, adjusted Cox models were used to estimate the association among parity, inter-pregnancy intervals, and excessive pregnancy weight gain in the first pregnancy and the relative hazard rate (HR) of obesity. Compared to nulliparous women, primiparous women with excessive pregnancy weight gain in the first pregnancy had a HR of obesity of 1.79 (95 % CI 1.40, 2.29); no significant difference was seen between primiparous without excessive pregnancy weight gain in the first pregnancy and nulliparous women. Among women with the same pregnancy weight gain in the first pregnancy and the same number of inter-pregnancy intervals (12 and 18 months or ≥18 months), the HR of obesity increased 2.43-fold (95 % CI 1.21, 4.89; p = 0.01) for every additional inter-pregnancy interval of <12 months; no significant association was seen for longer inter-pregnancy intervals. Among women with the same parity and inter-pregnancy interval pattern, women with excessive pregnancy weight gain in the first pregnancy had an HR of obesity 2.41 times higher (95 % CI 1.81, 3.21; p < 0.001) than women without. Primiparous and nulliparous women had similar obesity risk unless the primiparous women had excessive pregnancy weight gain in the first pregnancy, then their risk of obesity was greater. Multiparous women with the same excessive pregnancy weight gain in the first pregnancy and at least one additional short inter-pregnancy interval had a significant risk of obesity after childbirth. Perinatal interventions that prevent excessive pregnancy weight gain in the first pregnancy or lengthen the inter-pregnancy interval are necessary for reducing maternal obesity.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

References

  1. Gunderson, E. P., Quesenberry, C. P., Jr, Lewis, C. E., et al. (2004). Development of overweight associated with childbearing depends on smoking habit: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Obesity Research, 12, 2041–2053.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Davis, E. M., Zyzanski, S. J., Olson, C. M., Stange, K. C., & Horwitz, R. I. (2009). Racial, ethnic, and socioeconomic differences in the incidence of obesity related to childbirth. American Journal of Public Health, 99, 294–299.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Williamson, D. F., Madans, J., Pamuk, E., Flegal, K. M., Kendrick, J. S., & Serdula, M. K. (1994). A prospective study of childbearing and 10-year weight gain in US white women 25–45 years of age. International Journal of Obesity and Related Metabolic Disorders, 18, 561–569.

    CAS  PubMed  Google Scholar 

  4. Rosenberg, L., Palmer, J. R., Wise, L. A., Horton, N. J., Kumanyika, S. K., & Adams-Campbell, L. L. (2003). A prospective study of the effect of childbearing on weight gain in African-American women. Obesity Research, 11, 1526–1535.

    Article  PubMed  Google Scholar 

  5. Coitinho, D. C., Sichieri, R., & D’Aquino Benicio, M. H. (2001). Obesity and weight change related to parity and breast-feeding among parous women in Brazil. Public Health Nutrition, 4, 865–870.

    Article  CAS  PubMed  Google Scholar 

  6. Magann, E. F., Doherty, D. A., Chauhan, S. P., Klimpel, J. M., Huff, S. D., & Morrison, J. C. (2011). Pregnancy, obesity, gestational weight gain, and parity as predictors of peripartum complications. Archives of Gynecology and Obstetrics, 284, 827–836.

    Article  PubMed  Google Scholar 

  7. Brown, J. E., Kaye, S. A., & Folsom, A. R. (1992). Parity-related weight change in women. International Journal of Obesity and Related Metabolic Disorders, 16, 627–631.

    CAS  PubMed  Google Scholar 

  8. Heliovaara, M., & Aromaa, A. (1981). Parity and obesity. Journal of Epidemiology and Community Health, 35, 197–199.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Conde-Agudelo, A., & Belizan, J. M. (2000). Maternal morbidity and mortality associated with interpregnancy interval: Cross sectional study. BMJ, 321, 1255–1259.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Conde-Agudelo, A., Rosas-Bermudez, A., & Kafury-Goeta, A. C. (2007). Effects of birth spacing on maternal health: A systematic review. American Journal of Obstetrics and Gynecology, 196, 297–308.

    Article  PubMed  Google Scholar 

  11. Zhu, B. P., Haines, K. M., Le, T., McGrath-Miller, K., & Boulton, M. L. (2001). Effect of the interval between pregnancies on perinatal outcomes among white and black women. American Journal of Obstetrics and Gynecology, 185, 1403–1410.

    Article  CAS  PubMed  Google Scholar 

  12. Grisaru-Granovsky, S., Gordon, E. S., Haklai, Z., Samueloff, A., & Schimmel, M. M. (2009). Effect of interpregnancy interval on adverse perinatal outcomes–a national study. Contraception, 80, 512–518.

    Article  PubMed  Google Scholar 

  13. Rodrigues, T., & Barros, H. (2008). Short interpregnancy interval and risk of spontaneous preterm delivery. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 136, 184–188.

    Article  PubMed  Google Scholar 

  14. Zhu, B. P. (2005). Effect of interpregnancy interval on birth outcomes: Findings from three recent US studies. International Journal of Gynaecology and Obstetrics, 89(Suppl 1), S25–S33.

    Article  PubMed  Google Scholar 

  15. Villamor, E., Sparen, P., & Cnattingius, S. (2008). Interpregnancy weight gain and the male-to-female sex ratio of the second pregnancy: A population-based cohort study. Fertility and Sterility, 89, 1240–1244.

    Article  PubMed  Google Scholar 

  16. US Department of Labor. (2004). NLSY79 User’s guide (p. 393). Columbus, OH: Center for Human Resource Research.

    Google Scholar 

  17. Kaharuza, F. M., Sabroe, S., & Basso, O. (2001). Choice and chance: determinants of short interpregnancy intervals in Denmark. Acta Obstetricia et Gynecologica Scandinavica, 80, 532–538.

    Article  CAS  PubMed  Google Scholar 

  18. Miech, R., & Chilcoat, H. (2005). Maternal education and adolescent drug use: A longitudinal analysis of causation and selection over a generation. Social Science and Medicine, 60, 725–735.

    Article  PubMed  Google Scholar 

  19. Kwon, S., Lazo-Escalante, M., Villaran, M. V., & Li, C. I. (2012). Relationship between interpregnancy interval and birth defects in Washington State. Journal of Perinatology: Official Journal of the California Perinatal Association, 32, 45–50.

    Article  CAS  Google Scholar 

  20. Medicine Io. (1990). Nutrition during pregnancy. (pp. 1–468). Washington DC: National Academy Press.

  21. Obesity: preventing and managing the global epidemic. (2000). Report of a WHO consultation. World Health Organ Tech Rep Ser 894:i–xii, 1–253.

  22. National Center for Health Statistics. (2000). Clinical Growth Charts for the United States. In: Center for Disease Control and Prevention. Available at www.cdc.gov/nchs/about/major/nhanes/growthcharts/clinical_charts.htm. Accessed June 8, 2010.

  23. Dewey, K. G., & Cohen, R. J. (2007). Does birth spacing affect maternal or child nutritional status? A systematic literature review. Maternal & Child Nutrition, 3, 151–173.

    Article  Google Scholar 

  24. King, J. C. (2003). The risk of maternal nutritional depletion and poor outcomes increases in early or closely spaced pregnancies. The Journal of Nutrition, 133, 1732S–1736S.

    CAS  PubMed  Google Scholar 

  25. Council. IoMaNR. (2009). Weight gain during pregnancy: Reexamining the guidelines. In K. M. Rasmussen, & Yaktine, A. L. (Eds). Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: The National Academies Press.

  26. Olson, C. M., Strawderman, M. S., Hinton, P. S., & Pearson, T. A. (2003). Gestational weight gain and postpartum behaviors associated with weight change from early pregnancy to 1 year postpartum. International Journal of Obesity and Related Metabolic Disorders, 27, 117–127.

    Article  CAS  PubMed  Google Scholar 

  27. Viswanathan, M., Siega-Riz, A. M. & Moos, M. K. et al. (2008) Outcomes of maternal weight gain. Evidence report/technology assessment, 1–223.

  28. Gunderson, E. P., & Abrams, B. (2000). Epidemiology of gestational weight gain and body weight changes after pregnancy. Epidemiologic Reviews, 22, 261–274.

    Article  CAS  PubMed  Google Scholar 

  29. Chen, A., Feresu, S. A., Fernandez, C., & Rogan, W. J. (2009). Maternal obesity and the risk of infant death in the United States. Epidemiology, 20, 74–81.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Gunderson, E. P., Murtaugh, M. A., Lewis, C. E., Quesenberry, C. P., West, D. S., & Sidney, S. (2004). Excess gains in weight and waist circumference associated with childbearing: The Coronary Artery Risk Development in Young Adults Study (CARDIA). International Journal of Obesity and Related Metabolic Disorders, 28, 525–535.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  31. Brunner Huber, L. R. (2007). Validity of self-reported height and weight in women of reproductive age. Maternal and Child Health Journal, 11, 137–144.

    Article  PubMed  Google Scholar 

  32. Flegal, K. M., Carroll, M. D., Kit, B. K., & Ogden, C. L. (2012). Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA: The Journal of American Medical Association, 307, 491–497.

    Article  Google Scholar 

Download references

Acknowledgments

This publication was made possible by the Case Western Reserve University/Cleveland Clinic CTSA Grant Number UL1 RR024989 from the National Center for Research Resources, a component of the National Institutes of Health and NIH roadmap for Medical Research. Dr. Esa Davis was supported by a Harold Amos Medical Faculty Award from the Robert Wood Johnson Foundation, Grant #053501. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH or RWJ. This study has not received any funding support from a commercial organization.

Author information

Authors and Affiliations

  1. Department of Medicine, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA, 15213, USA

    Esa M. Davis

  2. Center for Clinical Investigation, Case Western Reserve University, Cleveland, OH, USA

    Denise C. Babineau & Xuelei Wang

  3. Department of Family Medicine, Case Western Reserve University, Cleveland, OH, USA

    Esa M. Davis & Stephen Zyzanski

  4. Department of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA

    Barbara Abrams

  5. Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    Lisa M Bodnar

  6. GalaxoSmithKline, Inc., Philadelphia, PA, USA

    Ralph I Horwitz

Authors
  1. Esa M. Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Denise C. Babineau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xuelei Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stephen Zyzanski
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Barbara Abrams
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lisa M Bodnar
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ralph I Horwitz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Esa M. Davis.

Electronic supplementary material

Below is the link to the electronic supplementary material.

10995_2013_1272_MOESM1_ESM.docx

Supplementary material 1 (DOCX 20 kb)

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Davis, E.M., Babineau, D.C., Wang, X. et al. Short Inter-pregnancy Intervals, Parity, Excessive Pregnancy Weight Gain and Risk of Maternal Obesity. Matern Child Health J 18, 554–562 (2014). https://doi.org/10.1007/s10995-013-1272-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-013-1272-3

Keywords

  • Pregnancy
  • Inter-pregnancy interval
  • Maternal obesity
  • Parity
  • Excessive pregnancy weight gain