Abstract
Objective:
To determine whether inadequate gestational weight gain in the second trimester in twin pregnancies is associated with an increased risk of preterm birth (PTB) at <32 weeks.
Study Design:
Retrospective cohort study including 489 twin pregnancies delivered between 2001 and 2013. Rates of weight gain at different gestational ages were compared with Institute of Medicine guidelines.
Result:
An inadequate rate of weight gain at <20 weeks was not associated with PTB. Patients with inadequate rates of weight gain at 20 to 28 weeks had a higher risk of PTB at <32 weeks (37.6%) compared to those with adequate weight gain (15.2%) (P<0.001). In multivariate analysis, women with inadequate weight gain at 20 to 28 weeks were 2.8 times more likely to deliver at <32 weeks (95% confidence interval 1.65 to 4.81).
Conclusion:
Inadequate gestational weight gain at 20 to 28 weeks in twin pregnancies was the strongest predictor of PTB at <32 weeks. This represents an optimal time for interventions to improve weight gain and potentially decrease rates of PTB.
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References
Luke B, Keith LG . The contribution of singletons, twins and triplets to low birth weight, infant mortality and handicap in the United States. J Reprod Med 1992; 37 (8): 661–666.
Dietz PM, Callaghan WM, Cogswell ME, Morrow B, Ferre C, Schieve LA . Combined effects of prepregnancy body mass index and weight gain during pregnancy on the risk of preterm delivery. Epidemiology 2006; 17 (2): 170–177.
Fox NS, Rebarber A, Roman AS, Klauser CK, Peress D, Saltzman DH . Weight gain in twin pregnancies and adverse outcomes: examining the 2009 Institute of Medicine guidelines. Obstet Gynecol 2010; 116 (1): 100–106.
González-Quintero VH, Kathiresan AS, Tudela FJ, Rhea D, Desch C, Istwan N . The association of gestational weight gain per institute of medicine guidelines and prepregnancy body mass index on outcomes of twin pregnancies. Am J Perinatol 2012; 29 (6): 435–440.
Schieve LA, Cogswell ME, Scanlon KS, Perry G, Ferre C, Blackmore-Prince C et al. Prepregnancy body mass index and pregnancy weight gain: associations with preterm delivery. The NMIHS Collaborative Study Group. Obstet Gynecol 2000; 96 (2): 194–200.
Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines Rasmussen KM, Yaktine AL editors. Weight Gain During Pregnancy: Reexamining the Guidelines. National Academies Press (US): Washington (DC), 2009.
Abrams B, Carmichael S, Selvin S . Factors associated with the pattern of maternal weight gain during pregnancy. Obstet Gynecol 1995; 86 (2): 170–176.
American College of Obstetricians and Gynecologists. ACOG Committee opinion no. 548: weight gain during pregnancy. Obstet Gynecol 2013; 121 (1): 210–212.
Pipe NG, Smith T, Halliday D, Edmonds CJ, Williams C, Coltart TM . Changes in fat, fat-free mass and body water in human normal pregnancy. Br J Obstet Gynaecol 1979; 86 (12): 929–940.
Committee on Practice Bulletins - Obstetrics, The American College of Obstetricians and Gynecologists. Practice bulletin no. 130: prediction and prevention of preterm birth. Obstet Gynecol 2012; 120 (4): 964–973.
Gardner B, Wardle J, Poston L, Croker H . Changing diet and physical activity to reduce gestational weight gain: a meta-analysis. Obes Rev 2011; 12 (7): e602–e620.
Streuling I, Beyerlein A, von Kries R . Can gestational weight gain be modified by increasing physical activity and diet counseling? A meta-analysis of interventional trials. Am J Clin Nutr 2010; 92 (4): 678–687.
Luke B, Brown MB, Misiunas R, Anderson E, Nugent C, van de Ven C, Burpee B, Gogliotti S . Specialized prenatal care and maternal and infant outcomes in twin pregnancy. Am J Obstet Gynecol 2003; 189 (4): 934–938.
Blomberg M . Maternal and neonatal outcomes among obese women with weight gain below the new Institute of Medicine recommendations. Obstet Gynecol 2011; 117 (5): 1065–1070.
Mamun AA, Kinarivala M, O'Callaghan MJ, Williams GM, Najman JM, Callaway LK . Associations of excess weight gain during pregnancy with long-term maternal overweight and obesity: evidence from 21 y postpartum follow-up. Am J Clin Nutr 2010; 91 (5): 1336–1341.
Rooney BL, Schauberger CW, Mathiason MA . Impact of perinatal weight change on long-term obesity and obesity-related illnesses. Obstet Gynecol 2005; 106 (6): 1349–1356.
Bloom SL, Yost NP, McIntire DD, Leveno KJ . Recurrence of preterm birth in singleton and twin pregnancies. Obstet Gynecol 2001; 98 (3): 379–385.
Esplin MS, O'Brien E, Fraser A, Kerber RA, Clark E, Simonsen SE et al. Estimating recurrence of spontaneous preterm delivery. Obstet Gynecol 2008; 112 (3): 516–523.
Kyrklund-Blomberg NB, Cnattingius S . Preterm birth and maternal smoking: risks related to gestational age and onset of delivery. Am J Obstet Gynecol 1998; 179 (4): 1051–1055.
Nicholson W, Croughan-Minihane M, Posner S, Washington AE, Kilpatrick SK . Preterm delivery in patients admitted with preterm labor: a prediction study. J Matern Fetal Med 2001; 10 (2): 102–106.
Patra J, Bakker R, Irving H, Jaddoe VW, Malini S, Rehm J . Dose-response relationship between alcohol consumption before and during pregnancy and the risks of low birthweight, preterm birth and small for gestational age (SGA)-a systematic review and meta-analyses. BJOG 2011; 118 (12): 1411–1421.
Ogden Cynthia L, Carroll Margaret D, Kit Brian K, Flegal Katherine M . Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 2014; 311 (8): 806–814.
McDonald SD, Pullenayegum E, Taylor VH, Lutsiv O, Bracken K, Good C et al. Despite 2009 guidelines, few women report being counseled correctly about weight gain during pregnancy. Am J Obstet Gynecol 2011; 205 (4): 333 e1-6.
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Pettit, K., Lacoursiere, D., Schrimmer, D. et al. The association of inadequate mid-pregnancy weight gain and preterm birth in twin pregnancies. J Perinatol 35, 85–89 (2015). https://doi.org/10.1038/jp.2014.160
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DOI: https://doi.org/10.1038/jp.2014.160
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