The association between gestational weight gain and perinatal outcomes among underweight women with twin pregnancy in Japan

Maeda, Yuto; Ogawa, Kohei; Morisaki, Naho; Sago, Haruhiko

doi:10.1002/ijgo.14122

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…In the present study, we found that a high GWG additionally increased HDP in twin pregnancies in agreement with previous findings by others 6,7 . Maeda et al recently confirmed this association even in underweight women 18 . Since we divided our study cohort into three groups of GWG using the same range for all BMI groups, our cut‐off for low GWG in obese women was higher than suggested by Lipworth et al 11 But even using this cut‐off, low GWG was significantly associated with increased risks for stillbirth and NICU admissions in obese women.…”

Section: Discussionsupporting

confidence: 94%

“… 6 , 7 Maeda et al recently confirmed this association even in underweight women. 18 Since we divided our study cohort into three groups of GWG using the same range for all BMI groups, our cut‐off for low GWG in obese women was higher than suggested by Lipworth et al 11 But even using this cut‐off, low GWG was significantly associated with increased risks for stillbirth and NICU admissions in obese women. We were able to assess the outcomes for underweight women and for rare outcomes such as stillbirth and perinatal mortality due to our larger cohort.…”

Section: Discussionmentioning

confidence: 89%

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Impact of maternal body mass index and gestational weight gain on maternal and neonatal outcomes in twin pregnancies

Schubert¹,

Timmesfeld

Noever³

et al. 2022

Acta Obstet Gynecol Scand

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Introduction To date, there have only been provisional recommendations about the appropriate gestational weight gain in twin pregnancies. This study aimed to contribute evidence to this gap of knowledge. Material and methods Using a cohort of 10 603 twin pregnancies delivered between 2000 and 2015 in the state of Hessen, Germany, the individual and combined impact of maternal body mass index and gestational weight gain on maternal and neonatal outcomes was analyzed using uni‐ and multivariable logistic regression models. The analysis used newly defined population‐based quartiles of gestational weight gain in women carrying twin pregnancies (Q1: <419.4 g/week [low weight gain], Q2–Q3: 419.4–692.3 g/week [optimal weight gain], Q4: >692.3 g/week [high weight gain]) and the World Health Organization body mass index classification. Results Pre‐pregnancy body mass index ≥25 kg/m2 was associated with significantly increased rates of cesarean deliveries (aOR1.2, 95% CI: 1.01–1.41) and pregnancy‐induced hypertensive disorders (aOR 1.53, 95% CI: 1.11–2.1) but not with any adverse neonatal outcome. Perinatal mortality (aOR 2.23, 95% CI: 1.38–3.6), preterm birth (aOR 1.88, 95% CI: 1.58–2.25), APGAR′5 < 7 (aOR 1.61, 95% CI: 1.19–2.17) and admissions to the neonatal intensive care unit (aOR 1.6, CI: 1.38–1.85) were increased among women with low gestational weight gain. Rates of cesarean deliveries were high in both women with low (aOR 1.25, 95% CI: 1.05–1.48) and high gestational weight gain (aOR 1.17, 95% CI: 1.01–1.35). A high gestational weight gain was also associated with higher rates of hypertensive disorders in pregnancy (aOR 2.32, 95% CI: 1.79–3.02) and postpartum hemorrhage (aOR 1.72, 95%CI: 1.12–2.63). The risk of preterm birth, low Apgar scores and NICU admissions showed a converse linear relation with pre‐pregnancy body mass index in women with low gestational weight gain. Conclusions In twin pregnancies, nonoptimal weekly maternal weight gain seems to be strongly associated with maternal and neonatal adverse outcomes. Since gestational weight gain is a modifiable risk factor, health care providers have the opportunity to counsel pregnant women with twins and target their care accordingly. Additional research to confirm the validity and generalizability of our findings in different populations is warranted.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 89%

Impact of maternal body mass index and gestational weight gain on maternal and neonatal outcomes in twin pregnancies

Schubert¹,

Timmesfeld

Noever³

et al. 2022

Acta Obstet Gynecol Scand

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show abstract

“…In a previous Chinese study, twin-pregnant women who gained weight above guidelines were more likely to have LGA >90th percentile and less likely to have LBW <2,500 g, 10 whereas preeclampsia was more frequent among excessive GWG twin-pregnant women, which was similar to our results. 10 14 28 29 30 It may be that EGWG leads to an increased maternal systemic inflammation response, and the resulting damage to vascular endothelial cells may cause preeclampsia. 31 Therefore, GWG would potentially be a preventable risk factor for preeclampsia.…”

Section: Discussionmentioning

confidence: 99%

Is the Gestational Weight Gain Recommended by the National Academy of Medicine Guidelines Suitable for Chinese Twin-Pregnant Women with Gestational Diabetes Mellitus?

Dai

Fan

et al. 2022

Am J Perinatol

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Objectives This study aimed to assess the applicability of the National Academy of Medicine (NAM) interim guidelines for twin pregnancies to the specific population of gestational diabetes mellitus by exploring the relationship between gestational weight gain and adverse pregnancy outcomes in Chinese twin-pregnant women with gestational diabetes mellitus. Study Design This was a retrospective cohort study of women diagnosed with diabetes in pregnancy between July 2017 and December 2020 at the Maternal and Child Health Hospital in Chongqing, China. The primary variable of interest was maternal total gestational weight gain. The primary outcomes were perinatal outcomes, which included: preeclampsia, small for gestational age, large for gestational age, low birth weight, neonatal pneumonia, neonatal respiratory distress syndrome, and neonatal intensive unit admission, etc. The association between inappropriate gestational weight gain and adverse pregnancy outcomes was estimated using multiple logistic regression analysis. Results A total of 455 twin-pregnant women who had gestational diabetes mellitus were analyzed. Women with low gestational weight gain had reduced risk of preeclampsia (adjusted odds ratio [aOR], 0.32; 95% CI or confidence interval, 0.17-0.63; p ¼ 0.001) and their infants had higher risks of small for gestational age (aOR, 1.93; 95% CI, 1.04-3.58; p ¼ 0.037), low birth weight (aOR, 2.27; 95% CI, 1.32-3.90;Ã Jiamiao Dai and Xiaoxiao Fan contributed equally and share the first authorship.

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Maternal and neonatal outcomes in women with twin pregnancies based on gestational weight gain: An updated systematic review and meta-analysis

Wang¹,

Yan²,

Xu³

et al. 2023

Pak J Med Sci

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Objective: This updated systematic review and meta-analysis aimed to assess maternal and fetal outcomes of pregnancies based on the Institute of Medicine (IOM) guidelines of gestational weight gain (GWG). Methods: PubMED, SCOPUS, EMBASE and Web of Science were searched up to 30th July 2022. All studies evaluating maternal and/or neonatal outcomes of twin pregnancies based on the IOM guidelines of gestational weight gain were included. Results: Twenty two studies were included. Mothers with twin pregnancies experiencing inadequate GWG showed higher incidence of gestational diabetes with the risk ratio (RR) 1.22 95% CI (0.95,1.57), p=0.0005, i2= 69% and premature rupture of membrane (PROM) with RR 1.14 95% CI (0.99, 1.30), p=0.07; i2=0% that coincided with higher rates of preterm birth, low birth weight, small for gestational age (SGA) and admission to NICU in neonates. Mothers with excessive GWG had higher risk of developing gestational hypertension with RR 1.59 95% CI (1.22, 2.07), p=0.0006, i2=75% and extremely preterm delivery (<32 weeks). Conclusion: Within the limitations of this review, GWG was found to be a predictable risk factor for adverse maternal and neonatal outcomes of twin pregnancies. doi: https://doi.org/10.12669/pjms.39.4.7529 How to cite this: Wang X, Yan M, Xu Z, Zhuang L. Maternal and neonatal outcomes in women with twin pregnancies based on gestational weight gain: An updated systematic review and meta-analysis. Pak J Med Sci. 2023;39(4):1166-1177. doi: https://doi.org/10.12669/pjms.39.4.7529 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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The association between gestational weight gain and perinatal outcomes among underweight women with twin pregnancy in Japan

Cited by 4 publications

References 22 publications

Impact of maternal body mass index and gestational weight gain on maternal and neonatal outcomes in twin pregnancies

Impact of maternal body mass index and gestational weight gain on maternal and neonatal outcomes in twin pregnancies

Is the Gestational Weight Gain Recommended by the National Academy of Medicine Guidelines Suitable for Chinese Twin-Pregnant Women with Gestational Diabetes Mellitus?

Maternal and neonatal outcomes in women with twin pregnancies based on gestational weight gain: An updated systematic review and meta-analysis

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