Investigation of optimal gestational weight gain for twin pregnancy in Southwest China: a retrospective study

Abstract

There is a lack of data on gestational weight gain (GWG) in twin pregnancies. We divided all the participants into two subgroups: the optimal outcome subgroup and the adverse outcome subgroup. They were also stratified according to prepregnancy body mass index (BMI): underweight (< 18.5 kg/m2), normal weight (18.5–23.9 kg/m2), overweight (24–27.9 kg/m2), and obese (≥ 28 kg/m2). We used 2 steps to confirm the optimal range of GWG. The first step was proposing the optimal range of GWG using a statistical-based method (the interquartile range of GWG in the optimal outcome subgroup). The second step was confirming the proposed optimal range of GWG via compared the incidence of pregnancy complications in groups below or above the optimal GWG and analyzed the relationship between weekly GWG and pregnancy complications to validated the rationality of optimal weekly GWG through logistic regression. The optimal GWG calculated in our study was lower than that recommended by the Institute of Medicine. Except for the obese group, in the other 3 BMI groups, the overall disease incidence within the recommendation was lower than that outside the recommendation. Insufficient weekly GWG increased the risk of gestational diabetes mellitus, premature rupture of membranes, preterm birth and fetal growth restriction. Excessive weekly GWG increased the risk of gestational hypertension and preeclampsia. The association varied with prepregnancy BMI. In conclusion, we provide preliminary Chinese GWG optimal range which derived from twin-pregnant women with optimal outcomes(16–21.5 kg for underweight, 15–21.1 kg for normal weight, 13–20 kg for overweight), except for obesity, due to the limited sample size.

Maternal and neonatal outcomes of twin pregnancies complicated by gestational diabetes mellitus

“…However, chronic hypertension during twin pregnancies have been shown to increase the risk of GDM [ 22 , 23 ]. Previous studies have shown that gestational weight gain during twin pregnancies in China ranges from 15 to 21 kg [ 20 , 21 ]. Excessive gestational weight gain has also been identified as a risk factor for hypertensive complications during pregnancy [ 24 ].…”

“…The following adverse maternal and neonatal outcomes were reported in our study: Pre-pregnancy BMI [ 19 ]: Underweight, BMI < 18.5; normal weight, 18.5 ≤ BMI < 24; overweight, 24 ≤ BMI < 28; obesity, BMI ≥ 28. Excessive gestational weight gain [ 20 , 21 ]: Total weight gain (TWG) or gestational gain BMI (GWGR) exceeded the established standards: underweight and normal weight, TWG ≥ 21 kg or GWGR ≥ 0.58; overweight, TWG ≥ 20 kg or GWGR ≥ 0.55; obesity, TWG ≥ 18 kg or GWGR ≥ 0.50. Preterm birth: before 34 or 37 complete weeks of gestation.…”

“…Excessive gestational weight gain [ 20 , 21 ]: Total weight gain (TWG) or gestational gain BMI (GWGR) exceeded the established standards: underweight and normal weight, TWG ≥ 21 kg or GWGR ≥ 0.58; overweight, TWG ≥ 20 kg or GWGR ≥ 0.55; obesity, TWG ≥ 18 kg or GWGR ≥ 0.50.…”