Perinatal Outcome and Change in Body Mass Index in Mothers of Dichorionic Twins: A Longitudinal Cohort Study

Simões, Teresinha; Cordeiro, Alexandra; Júlio, Catarina; Reis, Janildo Ludolf; Dias, Elsa; Blickstein, Isaac

doi:10.1375/twin.11.2.219

Cited by 11 publications

(13 citation statements)

References 13 publications

(25 reference statements)

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“…Preterm birth is the most important obstetric outcome. Many previous studies have investigated this subject and have found an association between GWG and preterm birth [15,[19][20][21][22]. However, the results are conflicting.…”

Section: Discussionmentioning

confidence: 99%

Gestational weight gain in twin pregnancies in Korea: application of the 2009 Institute of Medicine recommendations

Choi¹,

Hong²,

Jeon³

et al. 2020

Obstet Gynecol Sci

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Objective To investigate the effect of gestational weight gain (GWG) on maternal and neonatal outcomes based on the Institute of Medicine (IOM) guidelines for twin pregnancies. Methods This study included women with twin pregnancies who delivered at Seoul National University Bundang Hospital. Based on the weight gain per gestational week according to the 2009 IOM guidelines, the subjects were divided into the following 3 groups: inadequate, adequate, and excessive GWG. We compared the maternal and neonatal outcomes of each group. Results A total of 1,738 twin pregnancies were included in our study. Of these cases, 881, 694, and 163 (50.7%, 39.9%, and 9.4%, respectively) twin pregnancies were categorized into the inadequate, adequate, and excessive GWG groups, respectively. In the inadequate GWG group, the risks of preterm birth <34 weeks (aOR, 2.33, 95% confidence interval [CI], 1.63-3.34) and delivering neonates who were small for gestational age (aOR, 1.92, 95% CI, 1.42-2.60) were increased, and the risk of preeclampsia (aOR, 0.49, 95% CI, 0.32-0.76) was decreased. The excessive GWG group had an increased risk of the neonates being large for gestational age (aOR, 1.79, 95% CI, 1.15-2.81). Conclusion The 2009 IOM recommendations for GWG can be applied to Korean women with twin pregnancies to help achieve optimal maternal and neonatal outcomes. However, more than half of the women were categorized as having inadequate weight gain according to the guidelines. Further studies should be performed to obtain Korean national references for GWG in twin pregnancies.

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Section: Discussionmentioning

confidence: 99%

Gestational weight gain in twin pregnancies in Korea: application of the 2009 Institute of Medicine recommendations

Choi¹,

Hong²,

Jeon³

et al. 2020

Obstet Gynecol Sci

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show abstract

“…14 In contrast to our study findings, a prospective cohort of twin gestations found no association with weight gain and neonatal outcomes. 15 …”

Section: Commentmentioning

confidence: 99%

Weight gain in twin gestations: are the Institute of Medicine guidelines optimal for neonatal outcomes?

Lal

Kominiarek

2015

J Perinatol

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Objective To assess neonatal outcomes according to gestational weight gain (GWG) in twins Study Design This was a retrospective cohort study of twins delivered at ≥ 24 weeks. GWG was defined using the IOM guidelines as the referent. Birthweight and NICU admissions were compared with Chi-square and ANOVA tests, stratified by BMI. Results In all three BMI groups, mean birthweight of the larger and smaller twin increased as GWG increased, p<0.01. For the underweight/normal weight group, both twins < 2500 g, <1500 g and small for gestational age decreased significantly as GWG increased. Birthweight < 2500 g increased in all groups with GWG below the IOM guidelines, p < 0.01. In the multivariate analysis, both twins < 2500 g was significantly decreased with GWG above IOM guidelines. There was no difference in NICU admissions with GWG above the IOM guidelines. Conclusion GWG above the IOM guidelines may improve twin birthweights, with the findings most significant in underweight/normal weight women.

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“…Furthermore, some studies (Luke, 1998;Luke et al, 2003) used extrapolations of maternal weight gains rather than actual measurements. Others failed to take account of confounders such as maternal pre-pregnancy weights and unrecognised dietary interventions (Simões et al, 2008), as well clinical conditions such as gestational diabetes and preeclampsia.…”

Section: Maternal Weight Gain For Twin Pregnanciesmentioning

confidence: 99%

“…In contrast, Simões et al (2008) examined a prospective cohort of women expecting twins and measured BMI instead of monitoring weight gain. They conducted actual weight measurements and ensured there were no dietary interventions.…”

Section: Maternal Weight Gain For Twin Pregnanciesmentioning

confidence: 99%

Appropriate maternal weight gain in singleton and twin pregnancies: what is the evidence?

2012

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A review of the literature on maternal weight gain in singleton and twin pregnancies has identified two main messages. Firstly, that very little robust evidence exists on which to base advice to mothers about appropriate weight gain during pregnancy. Evidence that does exist has tended to be observational, or based on under-powered intervention studies and unable to provide definitive conclusions. Secondly, that although specific weight gains have been recommended by the Institute of Medicine (IOM) in the USA, many women who gained weight outside these guidelines apparently achieved successful pregnancy and birth outcomes, in part because there were numerous confounders. Crucially, resources need to be invested to address women's concerns with weight management, so that they can receive the necessary support from midwives and others who care for them. Currently, women tend to receive little advice on weight gain during pregnancy and it is vital they are made aware of the increased risks associated with obesity, and that opportunities to minimise complications should be available and accessible prior to and during pregnancy. Overall, these findings highlight the difficulties in drawing up recommendations for individual women, whether expecting twins or singletons, on the basis of studies of populations, and the distinct difference between the USA and the UK in how weight gain is rationalised.

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Perinatal Outcome and Change in Body Mass Index in Mothers of Dichorionic Twins: A Longitudinal Cohort Study

Cited by 11 publications

References 13 publications

Gestational weight gain in twin pregnancies in Korea: application of the 2009 Institute of Medicine recommendations

Gestational weight gain in twin pregnancies in Korea: application of the 2009 Institute of Medicine recommendations

Weight gain in twin gestations: are the Institute of Medicine guidelines optimal for neonatal outcomes?

Appropriate maternal weight gain in singleton and twin pregnancies: what is the evidence?

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