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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2019

Open Access 01-12-2019 | Premature Birth | Research article

The effect of gestational weight gain on perinatal outcomes among Chinese twin gestations based on Institute of Medicine guidelines

Authors: Dongxin Lin, Dazhi Fan, Shuzhen Wu, Gengdong Chen, Pengsheng Li, Huiting Ma, Shaoxin Ye, Jiaming Rao, Huishan Zhang, Meng Zeng, Yan Liu, Xiaoling Guo, Zhengping Liu

Published in: BMC Pregnancy and Childbirth | Issue 1/2019

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Abstract

Background

Gestational weight gain (GWG) has implications for perinatal outcomes, the guidelines for maternal weight gain, however, remain understudied among twin pregnancies. This study aimed to assess the associations between perinatal outcomes and GWG among twin pregnancies, based on the US institute of Medicine (IOM) 2009 guidelines.

Methods

A retrospective cohort study of pregnant women with viable twins ≥26 weeks of gestation, was conducted in Foshan, China, during July 2015 and June 2018. Maternal BMI was categorized based on Chinese standard and GWG was categorized as below, within and above the IOM 2009 recommendations. Underweight women were excluded for analysis. Perinatal outcomes were compared among these groups. To assess the independent impact of GWG on the perinatal outcomes, conventional multivariable regression and general estimated equation (GEE) were utilized for maternal outcomes and neonatal outcomes, respectively.

Results

A total of 645 mothers with twin pregnancies were included, of whom 15.0, 41.4 and 43.6% gained weight below, within and above guidelines, respectively. Compared to weight gain within guidelines, inadequate weight gain was associated with increased risks in spontaneous preterm birth < 37 weeks (aOR:3.55; 95% CI: 1.73–7.28) and < 35 weeks (aOR:2.63; 95% CI: 1.16–5.97). Women who gained weight above guidelines were more likely to have gestational hypertension disorder (aOR: 2.36; 95% CI: 1.32–4.21), pre-eclampsia (aOR: 2.59; 95% CI: 1.29–5.21) and have fetuses weighted >90th percentile and less likely to have fetuses weighted < 2500 g and < 1500 g.

Conclusions

Maintenance of gestational weight gain within the normal range could decrease the risk of adverse perinatal outcomes. However, the causality between pre-eclampsia and gestational weight gain requires further investigations.
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Metadata
Title
The effect of gestational weight gain on perinatal outcomes among Chinese twin gestations based on Institute of Medicine guidelines
Authors
Dongxin Lin
Dazhi Fan
Shuzhen Wu
Gengdong Chen
Pengsheng Li
Huiting Ma
Shaoxin Ye
Jiaming Rao
Huishan Zhang
Meng Zeng
Yan Liu
Xiaoling Guo
Zhengping Liu
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2019
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-019-2411-7

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