Weight gain during twin pregnancy with favorable pregnancy outcomes in Japan: A retrospective investigation for new criteria based on perinatal registry data.

Soichiro Obata,Mai Shimura,Shigeru Aoki,Toshihiro Misumi,Sayuri Nakanishi,Etsuko Miyagi,Ryosuke Shindo,Frank T Spradley

doi:10.1371/journal.pone.0253596

Abstract

In 2009, the United States Institute of Medicine (IOM) reported the optimal gestational weight gain (GWG) during twin pregnancy based on the pre-pregnancy body mass index (BMI). However, there are ethnic variations in the relationship between GWG and pregnancy outcomes. We aimed to establish the criteria for optimal GWG during twin pregnancy in Japan. The study included cases of dichorionic diamniotic twin pregnancy registered in the Japan Society of Obstetrics and Gynecology Successive Pregnancy Birth Registry System between 2013 and 2017. We analyzed data for cases wherein both babies were appropriate for gestational age and delivered at term. Cases were classified into four groups based on the pre-pregnancy BMI: underweight (BMI <18.5 kg/m2), normal weight (18.5 kg/m2 ≤BMI< 25.0 kg/m2), overweight (25.0 kg/m2 ≤BMI< 30.0 kg/m2), and obese (BMI ≥30.0 kg/m2) and we calculated the 25th–75th percentile range for GWG for the cases. The 3,936 cases were included. The GWG ranges were 11.5–16.5 kg, 10.3–16.0 kg, 6.9–14.7 kg, and 2.2–11.7 kg in the underweight, normal weight, overweight, and obese groups, respectively. Thus, in the current study, the optimal GWG during twin pregnancy was lower than that specified by the IOM criteria. Factoring this in maternal management may improve the outcomes of twin pregnancies in Japan.

Highlights

Insufficient gestational weight gain (GWG) during pregnancy leads to an increase in the rates of preterm delivery and small for gestational age (SGA) births [1,2]
In 2009, the United States Institute of Medicine (IOM) reported that the optimal GWG for twin pregnancy based on the pre-pregnancy body mass index (BMI) was as follows: 16.8–24.5 kg for normal weight (18.5 kg/m2 BMI< 25.0 kg/m2), 14.1–22.7 kg for overweight (25.0 kg/m2 BMI< 30.0 kg/m2), and 11.3–19.1 kg for obese (BMI 30.0 kg/m2) categories [8]
According to the BMIs, 1,011, 4,974, 513, and 148 women were classified into the underweight, normal weight, overweight, and obese groups, respectively

Summary

Introduction

Insufficient gestational weight gain (GWG) during pregnancy leads to an increase in the rates of preterm delivery and small for gestational age (SGA) births [1,2]. In 2009, the United States Institute of Medicine (IOM) reported that the optimal GWG for twin pregnancy based on the pre-pregnancy body mass index (BMI) was as follows: 16.8–24.5 kg for normal weight (18.5 kg/m2 BMI< 25.0 kg/m2), 14.1–22.7 kg for overweight (25.0 kg/m2 BMI< 30.0 kg/m2), and 11.3–19.1 kg for obese (BMI 30.0 kg/m2) categories [8]. Optimal weight gain during twin pregnancy in Japan had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. https://www.jsps.go.jp/j-grantsinaid/

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