Pregnancy outcome according to gestational weight gain in twin pregnancies on the basis of the 2009 Institute of Medicine (IOM) recommendations

Abstract

Objective: The aim of this study was to investigate the effect of gestational weight gain on pregnancy outcome in twin pregnancies according to prepregnancy body mass index (BMI), on the basis of 2009 Institute of Medicine (IOM) recommendations. Methods: One hundred ninety-eight twin pregnancy women and their 396 neonates who delivered in Yonsei University Health System from January 1st, 2005 to April 30th, 2010. Maternal height, maternal weight in prepregnancy and gestational weight gain were retrospectively reviewed. Women were grouped into four categories of BMI: underweight (), normal weight (18.5~24.9 kg/), overweight (25~29.9 kg/) and obese (30 kg/). Gestational weight gain was categorized as Less if it was below the IOM's recommended range for the woman's prepregnancy BMI, Within if it was within the range, and More if it was above the range. Results: Underweight with Less or Within maternal weight gain groups were associated with significantly increased odds for small for gestational age (Less, odds ratio [OR] 6.5, confidence interval [CI] 1.75~24.14; Within, OR 3.55, CI 1.37~9.14) and More weight gain with overweight or obesity groups were associated with significantly increased odds for large for gestational age (overweight, OR 6.25, CI 1.14~34.32; obesity, OR 8.33, CI 1.14~47.93). Overweight or obese women and excessive gestational weight gain were associated with significantly increased odds of pregnancy induced hypertension (overweight: OR 7.04, CI 1.04~47.78, obesity: OR 10.56, CI 1.32~84.14) and gestational diabetes mellitus (overweight: OR 13.2, CI 1.78~97.74, obesity: OR 19.8, CI 2.29~171.02). Conclusion: Overweight or obese women with excessive gestational weight gain were associated with significantly increased risk of adverse pregnancy outcome in twin pregnancies. Therefore, physician should pay attention not only to prepregnancy BMI but also to maternal weight gain. A large prospective study is necessary to confirm the relationships between gestational weight gain and pregnancy outcome in twin pregnancies.