Gestational Weight Gain per Pre-Pregnancy Body Mass Index and Birth Weight in Twin Pregnancies: A Cohort Study in Wuhan, China

Yawen Chen,Yiming Zhang,Mingzhu Liu,Yan Liu,Yong Gan,Ronghua Hu,Michael G Vaughn,Shiyi Cao,Zhengmin Qian,Hong Xian,Bin Zhang

doi:10.1038/s41598-018-29774-z

Abstract

To assess the relationship between gestational weight gain (GWG) of twin-pregnancy women and twin birth weights, as well as to evaluate whether pre-pregnancy body mass index (BMI) influences this relationship. A cohort study was conducted in Wuhan, China, between 1/01/2011 and 8/31/2017. Women with twin pregnancies who delivered live and non-malformed twins were included (6,925 women and 13,850 infants), based on the Wuhan Maternal and Child Health Management Information System. Logistic regression models were employed to examine the association between GWG and paired small for gestational age (SGA, defined as birth weight <10th percentile for gestational age and sex)/SGA and linear regression models were utilized to explore the relationship between GWG and sum of birth weights. The associations of GWG based on both the IOM and Chinese recommendations and SGA/SGA pairs were obtained, as well as the stratified analyses by pre-pregnancy BMI. Additionally, the sum birth weight of one twin pair increased by 15.88 g when the GWG increased by 1 kg. GWG below the IOM and Chinese recommendations was associated with an increased risk of SGA/SGA pairs in all pre-pregnancy BMI categories. However, in underweight, overweight, and obese women, the association between GWG above the IOM and Chinese recommendations and SGA/SGA pairs changed with adjustment.

Highlights

Gestational weight gain (GWG) is an important indicator for monitoring and evaluating the nutritional status of pregnant women[1]
Birth weights were examined among twins, based on the Institute of Medicine (IOM) and Chinese recommended gestational weight gain (GWG), and presented in Table 4. 148 women (2.14%) delivered small for gestational age (SGA)/SGA paired
Given the dearth of evidence surrounding the association of GWG in women with twin pregnancies in large sample and in non-western industrialized nations, the present study sought to fill this gap

Summary

Introduction

Gestational weight gain (GWG) is an important indicator for monitoring and evaluating the nutritional status of pregnant women[1]. In order to improve representativeness and provide more data, there is a critical need to expand sample size to evaluate the relationship of GWG in twin pregnancies and relevant outcomes This cohort study was conducted and based on both the Chinese adult BMI categories and the IOM GWG recommendations in twin pregnancies to elucidate the association of GWG and birth weights. This association was stratified by per pre-pregnancy BMI among a population of women with twin-pregnancy in Wuhan, China

Methods

Results

Conclusion