Keywords
Weight gain
Pregnancy outcome
Submitted : 2024-02-23
Accepted : 2024-03-09
Published : 2024-03-24
Abstract
Objective: To investigate the effects of maternal body mass index (BMI) and gestational weight gain on maternal and neonatal outcomes in twin pregnancies. Methods: Five hundred cases of twin pregnancies were divided into a low body weight group (68 cases), a normal weight group (355 cases), an overweight group (65 cases), and an obesity group (12 cases) according to the World Health Organization (WHO) Body Mass Index (BMI) classification guidelines Results: Comparison of weight gain during different pregnancies revealed that pregnant women were mainly of low weight and average weight. The higher the BMI before pregnancy, the higher the incidence of excessive weight gain during pregnancy. The incidences of gestational diabetes mellitus (GDM) and premature rupture of membranes in women with low weight gain were significantly higher than those in women with average weight gain and high weight gain (P < 0.05). The incidences of gestational hypertension, preeclampsia, and anemia in women with high weight gain were significantly higher than those in women with low weight gain and average weight gain (P < 0.05). The incidence of neonatal birth weight, fetal distress, and macrosomia in the high weight gain group was significantly higher than those in the low weight gain and average weight gain groups (P < 0.05). The birth weight of newborns in low-weight gain mothers was significantly lower than that of normal-weight gain mothers (P < 0.05). Conclusion: Poor maternal and infant outcomes were common in women with insufficient or excessive weight gain during pregnancy. Therefore, for women with twin pregnancies, weight management is crucial to ensure maternal and infant health.
References
Ananth CV, Chauhan SP, 2012, Epidemiology of Twinning in Developed Countries. Semin Perinatol, 36: 156–61.
Martin JA, Hamilton BE, Osterman MJ, 2012, Three Decades of Twin Births in the United States, 1980–2009. NCHS Data Brief, 80:1–8.
Deng C, Dai L, Yi L, et al., 2019, Temporal Trends in the Birth Rates and Perinatal Mortality of Twins: A Population-Based Study in China. PLoS ONE, 14: e0209962.
Chauhan SP, Scardo JA, Hayes E, et al., 2010, Twins: Prevalence, Problems, and Preterm Births. Am J Obstet Gynecol, 203: 305–15.
Rao A, Sairam S, Shehata H, 2004, Obstetric Complications of Twin Pregnancies. Best Pract Res Clin Obstet Gynaecol, 18: 557–76.
Committee on Practice Bulletins-Obstetrics, Society for Maternal-Fetal Medicine, 2016, Practice Bulletin No. 169: Multifetal Gestations: Twin, Triplet, and Higher-Order Multifetal Pregnancies. Obstet Gynecol, 128: e131–46.
Santana DS, Cecatti JG, Surita FG, et al., Twin Pregnancy and Severe Maternal Outcomes: The World Health Organization Multicountry Survey on Maternal and Newborn Health. Obstet Gynecol, 127: 631–41.
Liu L, Johnson HL, Cousens S, et al., 2012, Global, Regional, and National Causes of Child Mortality: An Updated Systematic Analysis for 2010 with Time Trends Since 2000. Lancet, 379: 2151–61.
Martin JA, Hamilton BE, Ventura SJ, et al., 2013, Births: Final Data for 2011. Natl Vital Stat Rep, 62: 1–69 + 72.
Kazemier BM, Buijs PE, Mignini L, et al., 2014, Impact of Obstetric History on the Risk of Spontaneous Preterm Birth in Singleton and Multiple Pregnancies: A Systematic Review. BJOG, 121:1197–208.
Dickey RP, Xiong X, Gee RE, et al., 2012, Effect of Maternal Height and Weight on the Risk of Preterm Birth in Singleton and Twin Births Resulting from In Vitro Fertilization: A Retrospective Cohort Study Using the Society for Assisted Reproductive Technology Clinic Outcome Reporting System. Fertil Steril, 97: 349–54.
Marleen S, Dias C, Nandasena R, et al., 2020, Association Between Chorionicity and Preterm Birth in Twin Pregnancies: A Systematic Review Involving 29864 Twin Pregnancies. BJOG, 128(5): 788–796.
Bodnar LM, Himes KP, Abrams B, et al., 2019, Gestational Weight Gain and Adverse Birth Outcomes in Twin Pregnancies. Obstet Gynecol, 134(5): 1075–86.
Lin D, Fan D, Wu S, et al., 2019, The Effect of Gestational Weight Gain on Perinatal Outcomes Among Chinese Twin Gestations Based on Institute of Medicine Guidelines. BMC Pregnancy Childbirth, 19: 262.
Marleen S, Hettiarachchi J, Dandeniya R, et al., 2018, Maternal Clinical Predictors of Preterm Birth in Twin Pregnancies: A Systematic Review Involving 2,930,958 Twin Pregnancies. Eur J Obstet Gynecol Reprod Biol, 230:159–171.
Conde-Agudelo A, Romero R, 2014, Prediction of Preterm Birth in Twin Gestations Using Biophysical and Biochemical Tests. Am J Obstet Gynecol, 211: 583–95.
World Health Organization Technical Report Series, 2000, Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation, World Health Organization, Geneva, Switzerland, 894.
Institution of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation, 1990, Nutrition During Pregnancy: Part I, Weight Gain: Part II, Nutrient Supplements, Natl Academy Pr, Washington (DC), 10.
Monden C, Pison G, Smits J, 2021, Twin Peaks: More Twinning in Humans Than Ever. Hum Reprod, 36(6): 1666–1673.
Santana DS, Silveira C, Costa ML, et al., 2018, Perinatal Outcomes in Twin Pregnancies Complicated by Maternal Morbidity: Evidence from the WHO Multicountry Survey on Maternal and Newborn Health. BMC Pregnancy Childbirth, 18: 449.
The ESHRE Capri Workshop Group, 2000, Multiple Gestation Pregnancy. Hum Reprod, 15(8): 1856–1864.
Roman A, Ramirez A, Fox NS, 2022, Screening for Preterm Birth in Twin Pregnancies. Am J Obstet Gynecol MFM, 4(2): 100531.
Li S, Gao J, Liu J, et al., 2021, Perinatal Outcomes and Risk Factors for Preterm Birth in Twin Pregnancies in a Chinese Population: A Multi-center Retrospective Study. Front Med, 2021(8): e657862.
Zhou S, Yang Y, Zhang X, et al., 2021, Perinatal Outcomes of Twin Pregnancies with Preterm Premature Rupture of the Membranes At 24–34 Weeks Gestation. Sci Rep, 11: 23419.
Refuerzo JS, Momirova V, Peaceman AM, et al., 2010, Neonatal Outcomes in Twin Pregnancies Delivered Moderately Preterm, Late Preterm, and Term. Am J Perinatol, 27(7): 537–542.
Kominiarek MA, Peaceman AM, 2017, Gestational Weight Gain. Am J Obstet Gynecol. 217(6): 642–651.
Crane JM, White J, Murphy P, et al., 2009, The Effect of Gestational Weight Gain by Body Mass Index on Maternal and Neonatal Outcomes. J Obstet Gynaecol Can, 31: 28–35.
Strauss RS, Dietz WH, 1999, Low Maternal Weight Gain in the Second or Third Trimester Increases the Risk for Intrauterine Growth Retardation. J Nutr, 129: 988–93.
Viswanathan M, Siega-Riz AM, Moos MK, et al., 2008, Outcomes of Maternal Weight Gain. Evid Rep Technol Assess (Full Rep), 2008(168): 1–223.
Bodnar LM, Himes KP, Abrams B, et al., 2019, Gestational Weight Gain and Adverse Birth Outcomes in Twin Pregnancies. Obstet Gynecol, 134: 1075–86.
Luke B, Gillespie B, Min SJ, et al., 1997, Critical Periods of Maternal Weight Gain: Effect on Twin Birth Weight. Am J Obstet Gynecol, 177: 1055–62.
Luke B, Min SJ, Gillespie B, et al., 1998, The Importance of Early Weight Gain in Twins’ Intrauterine Growth and Birth Weight. Am J Obstet Gynecol, 179: 1155–61.
Rasmussen KM, Yaktine AL, (eds), 2009, Weight Gain During Pregnancy: Reexamining the Guidelines, National Academic Press, Washington, http://www.ncbi.nlm.nih.gov/books/NBK32813/
Lipworth H, Barrett J, Murphy KE, et al., 2022, Gestational Weight Gain in Twin Gestations and Pregnancy Outcomes: A Systematic Review and Meta-Analysis. BJOG, 129: 868–79.
Lipworth H, Melamed N, Berger H, et al., 2021, Maternal Weight Gain and Pregnancy Outcomes in Twin Gestations. Am J Obstet Gynecol, 225(2): 523.e1–532.e12.