Perinatal outcomes based on the institute of medicine guidelines for weight gain in twin pregnancies

Shamshirsaz, Amirhoushang A.; Haeri, Sina; Ravangard, Samadh F.; Sangi‐Haghpeykar, Haleh; Gandhi, Manisha; Ozhand, Ali; Spiel, Melissa; Trout, Susanne; Sadowski, Allison; Hussain, Naveed; Campbell, Winston A.; Shamshirsaz, Alireza A.

doi:10.3109/14767058.2013.836177

Cited by 41 publications

(51 citation statements)

References 5 publications

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“…This could also explain the conflicting published data; the incidence of pre-eclampsia has been reported to be higher in women with high GWG, 14,17,21 and has been reported as being similar among all patients with twin pregnancies. 9,10,16,25 To the best of our knowledge, no previous research has investigated the effect of maternal GWG on perinatal mortality among dichorionic twin pregnancies and the present study is the first one to examine this problem. The range of GWG ratios associated with a reduced probability of perinatal mortality in the present study was wider than GWG levels recommended by IOM.…”

Section: Discussionmentioning

confidence: 94%

Observational study of associations between gestational weight gain and perinatal outcomes in dichorionic twin pregnancies

Kosińska-Kaczyńska

Szymusik

Kaczynski

et al. 2017

Intl J Gynecology & Obste

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Section: Discussionmentioning

confidence: 94%

Observational study of associations between gestational weight gain and perinatal outcomes in dichorionic twin pregnancies

Kosińska-Kaczyńska

Szymusik

Kaczynski

et al. 2017

Intl J Gynecology & Obste

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“…Several studies have attempted to examine the 2009 recommendations for twin gestations, with conflicting results. Only a few studies considered SGA <10th percentile specifically, and of those that did, one did not find a significant difference between women [ 29 ], while another found a lower incidence in normal weight women who gained within or above guidelines, but no differences in overweight or obese women [ 9 ]. A number of studies called into question the provisional recommendations as they found that weight gain in accordance with or in excess of the guidelines was associated with larger birth weight and decreased incidence of prematurity [ 30 – 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Other studies corroborated these results, as excessive GWG was associated with a larger birth weight, without any significant increases in other adverse pregnancy outcomes [ 33 ]. Conversely, another study found both inadequate and excess weight gain were associated with lower birth weight and prematurity [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Examining the provisional guidelines for weight gain in twin pregnancies: a retrospective cohort study

Lutsiv

Hulmán

Woolcott

et al. 2017

BMC Pregnancy Childbirth

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BackgroundWeight gain during pregnancy has an important impact on maternal and neonatal health. Unlike the Institute of Medicine (IOM) recommendations for weight gain in singleton pregnancies, those for twin gestations are termed “provisional”, as they are based on limited data. The objectives of this study were to determine the neonatal and maternal outcomes associated with gaining weight below, within and above the IOM provisional guidelines on gestational weight gain in twin pregnancies, and additionally, to explore ranges of gestational weight gain among women who delivered twins at the recommended gestational age and birth weight, and those who did not.MethodsA retrospective cohort study of women who gave birth to twins at ≥20 weeks gestation, with a birth weight ≥ 500 g was conducted in Nova Scotia, Canada (2003–2014). Our primary outcome of interest was small for gestational age (<10th percentile). In order to account for gestational age at delivery, weekly rates of 2nd and 3rd trimester weight gain were used to categorize women as gaining below, within, or above guidelines. We performed traditional regression analyses for maternal outcomes, and to account for the correlated nature of the neonatal outcomes in twins, we used generalized estimating equations (GEE).ResultsA total of 1482 twins and 741 mothers were included, of whom 27%, 43%, and 30% gained below, within, and above guidelines, respectively. The incidence of small for gestational age in these three groups was 30%, 21%, and 20%, respectively, and relative to gaining within guidelines, the adjusted odds ratios were 1.44 (95% CI 1.01–2.06) for gaining below and 0.92 (95% CI 0.62–1.36) for gaining above. The gestational weight gain in women who delivered twins at 37–42 weeks with average birth weight ≥ 2500 g and those who delivered twins outside of the recommend ranges were comparable to each other and the IOM recommendations.ConclusionsWhile gestational weight gain below guidelines for twins was associated with some adverse neonatal outcomes, additional research exploring alternate ranges of gestational weight gain in twin pregnancies is warranted, in order to optimize neonatal and maternal outcomes.Electronic supplementary materialThe online version of this article (10.1186/s12884-017-1530-2) contains supplementary material, which is available to authorized users.

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“…7 More recently, one study showed that gestational weight gain at the IOM guidelines resulted in the best neonatal outcomes; and, interestingly, there was an increased risk of preterm delivery and low birth weights at all other gestational weight gain categories, whether higher or lower than the IOM guidelines. 16 …”

Section: Commentmentioning

confidence: 99%

“…We chose to include all women at ≥ 24 weeks gestation, with correction of total gestational weight gain by the number of weeks of gestation, as previously defined in other studies. 8,9,16 We chose to follow this similar and previously published approach of dividing total gestational weight gain by gestational weeks at delivery. With this approach, we were able to evaluate gestational weight gain both less than and above the IOM guidelines, and made comparisons to gestational weight gain at the IOM guidelines.…”

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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Perinatal outcomes based on the institute of medicine guidelines for weight gain in twin pregnancies

Cited by 41 publications

References 5 publications

Observational study of associations between gestational weight gain and perinatal outcomes in dichorionic twin pregnancies

Observational study of associations between gestational weight gain and perinatal outcomes in dichorionic twin pregnancies

Examining the provisional guidelines for weight gain in twin pregnancies: a retrospective cohort study

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

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