Prepregnancy overweight and obesity are associated with higher risk of perinatal complications. However, the effect of weight change prior to pregnancy on perinatal outcome is largely unknown. Therefore, it is aimed to examine the impact on perinatal outcomes of interpregnancy BMI change in women of different BMI categories. The MEDLINE, EMBASE, LILACS, and CINAHL databases were searched (1990‐August 2019). Observational studies on interpregnancy BMI change were selected. Outcomes evaluated were gestational diabetes mellitus (GDM), preeclampsia, gestational hypertension (GH), cesarean section, preterm birth, and newborns being large (LGA) or small (SGA) for gestational age. Meta‐analyses and meta‐regression analyses were executed. Thirty studies were included (n > 1 million). Interpregnancy BMI gain was associated with a higher risk of GDM (for BMI gain ≥3 kg/m²: OR 2.21; [95%CI 1.53‐3.19]), preeclampsia (1.77 [1.53‐2.04]), GH (1.78 [1.61‐1.97]), cesarean section (1.32 [1.24‐1.39]), and LGA (1.54 [1.28‐1.86]). The effects of BMI gain were most pronounced in women with BMI <25 kg/m² before the first pregnancy regarding GDM, GH, and cesarean section. Except for LGA, interpregnancy BMI loss did not result in a decreased risk of perinatal complications. In this study, women of normal weight who gain weight before pregnancy were identified as a high‐risk population for perinatal complications. This emphasizes that weight management is important for women of all BMI categories and a pregnancy wish.

中文翻译：

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孕期体重变化对妇女及其子女围生期结局的影响：系统评价和荟萃分析。

孕前超重和肥胖与围产期并发症的高风险相关。但是，怀孕前体重变化对围产期结局的影响尚不清楚。因此，本研究旨在探讨不同BMI类别女性的孕前BMI变化对围产期结局的影响。检索了MEDLINE，EMBASE，LILACS和CINAHL数据库（1990年8月至2019年8月）。选择关于妊娠期BMI变化的观察性研究。评估的结果是妊娠糖尿病（GDM），先兆子痫，妊娠高血压（GH），剖宫产，早产，以及胎龄大（LGA）或小（SGA）的新生儿。进行荟萃分析和荟萃回归分析。纳入了30项研究（n> 1百万）。²：OR 2.21；[95％CI 1.53-3.19]，先兆子痫（1.77 [1.53-2.04]），GH（1.78 [1.61-1.97]），剖宫产（1.32 [1.24-1.39]）和LGA（1.54 [1.28-1.86]） ）。对于第一次妊娠前BMI <25 kg / m ²的女性，BDM增高的影响在GDM，GH和剖宫产方面最为明显。除LGA外，妊娠间BMI的损失并未导致围产期并发症的风险降低。在本研究中，体重正常且在怀孕前体重增加的妇女被确定为围产期并发症的高危人群。这强调了体重控制对于所有BMI类别和怀孕愿望的女性都很重要。