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Am J Perinatol 2017; 34(13): 1293-1301
DOI: 10.1055/s-0037-1603318
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Achievement of Body Mass Index Specific Weight Gain Recommendations: Impact on Preterm Birth in Twin Pregnancies

Candice W. Greenan
1   Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina
,
Roger B. Newman
1   Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina
,
Barbara Wojciechowski
2   Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
,
Colleen J. Christensen
3   Furman University, Greenville, South Carolina
› Author Affiliations
Further Information

Publication History

23 March 2017

28 March 2017

Publication Date:
15 May 2017 (online)

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Abstract

Objective To determine whether achievement of body mass index specific weight gain recommendations is associated with reduced preterm birth or neonatal morbidity among twin gestations.

Study Design This was a retrospective cohort study of twin gestations delivered at the Medical University of South Carolina from 2000 to 2010. In total, 588 women in all prepregnancy body mass index categories who delivered ≥24 weeks' gestation were included. Women were grouped as achieved or underachieved based on total weight gain and gestational age at delivery. Maternal and neonatal outcomes were compared between the groups.

Results Body mass index specific weight gain goals were achieved by 59.9% of women. The achieved group had a 1.5-fold reduction in the rate of preterm birth <32 weeks (18.8 vs. 30.5%; p = 0.001). Achievers had larger mean birthweights (2,146 ± 584 g vs. 1,859 ± 593 g; p < 0.001) and were significantly less likely to deliver either twin with a birthweight less than the 10th percentile for gestational age (larger twin 0.6 vs. 4.7%, p = 0.001; smaller twin 12.2 vs. 21.6%, p = 0.002). Composite neonatal morbidity, days on the respirator, length of hospital stay, and rate of neonatal intensive care unit admission were significantly decreased in the achieved group.

Conclusion Achievement of body mass index specific weight gain goals improves preterm birth rates, neonatal birthweights, and composite neonatal outcomes in women carrying twins.

Keywords

gestational weight gain - maternal weight gain - neonatal morbidity - preterm birth - twin pregnancy

Note

The study was presented as posters #422 and #282 at the 36th annual meeting of the Society for Maternal-Fetal Medicine, Atlanta, GA, February 2–6, 2016. This article represents the views of the author and not those of Veterans Health Administration.


 

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