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Gestational weight gain charts for twin pregnancies in Southeast China.

ABSTRACT: BACKGROUND:To establish age-standardized charts of weight gain for term twin pregnancies in Southeast China. METHODS:We designed a retrospective study on data from women pregnant with twins, a gestational age beyond 36?weeks and an average weight???2500?g. We established hierarchical linear regression models to express gestational weight gain patterns. RESULTS:We analyzed data from 884 women pregnant with twins (151 underweight, 597 normal weight, and 136 overweight). Our final models fit the crude weight measurement data well. The means of weight gain generally decreased as the pre-pregnancy BMI increased. For each BMI category, the mean weight gains increased with the gestational age and the standard deviation increased slightly. The mean weight gains were 18.82?±?6.73, 18.53?±?6.74, and 16.97?±?6.95?kg at 37?weeks in underweight, normal weight, and overweight women, respectively. CONCLUSION:The weight gain chart can be used to estimate maternal weight gain to be gestational age-standardized z scores by pre-pregnancy BMI and may serve as an innovative tool for perinatal care providers to guide the weight gain of women pregnant with twins.

SUBMITTER: Lin L

PROVIDER: S-EPMC7041099 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Gestational weight gain charts for twin pregnancies in Southeast China.

Lin Lihua L Lin Juan J Mao Xiaodan X Xu Libo L Zhang Ronghua R Luo Jinying J Lin Yingying Y Yan Jianying J Yan Jianying J

BMC pregnancy and childbirth 20200224 1

<h4>Background</h4>To establish age-standardized charts of weight gain for term twin pregnancies in Southeast China.<h4>Methods</h4>We designed a retrospective study on data from women pregnant with twins, a gestational age beyond 36 weeks and an average weight ≥ 2500 g. We established hierarchical linear regression models to express gestational weight gain patterns.<h4>Results</h4>We analyzed data from 884 women pregnant with twins (151 underweight, 597 normal weight, and 136 overweight). Our f ...[more]

PMID: 32093673

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Project description:BackgroundMonitoring gestational weight gain (GWG) is fundamental to ensure a successful pregnancy for the mother and the offspring. There are several international GWG charts, but just a few for low- and middle-income countries.ObjectivesTo construct GWG charts according to pre-pregnancy BMI for Brazilian women.MethodsThis is an individual patient data analysis using the Brazilian Maternal and Child Nutrition Consortium data, comprising 21 cohort studies. External validation was performed using "Birth in Brazil," a nationwide study. We selected adult women with singleton pregnancies who were free of infectious and chronic diseases, gestational diabetes, and hypertensive disorders; who delivered a live birth at term; and whose children were adequate for gestational age, and with a birth weight between 2500-4000 g. Maternal self-reported pre-pregnancy weight and weight measured between 10-40 weeks of gestation were used to calculate GWG. Generalized Additive Models for Location, Scale and Shape were fitted to create GWG charts according to gestational age, stratified by pre-pregnancy BMI.ResultsThe cohort included 7086 women with 29,323 weight gain measurements to construct the charts and 4711 women with 31,052 measurements in the external validation. The predicted medians for GWG at 40 weeks, according to pre-pregnancy BMI, were: underweight, 14.1 kg (IQR, 10.8-17.5 kg); normal weight, 13.8 kg (IQR, 10.7-17.2 kg); overweight, 12.1 kg (IQR, 8.5-15.7 kg); obesity, 8.9 kg (IQR, 4.8-13.2 kg). The 10th, 25th, 50th, 75th, and 90th percentiles were estimated. Results for internal and external validation showed that the percentages below the selected percentiles were close to those expected.ConclusionsThe charts proposed provide a description of GWG patterns according to gestational age and pre-pregnancy BMI among healthy Brazilian women with good neonatal outcomes. The external validation indicates that this new tool can be used to monitor GWG in the primary health-care setting and to test potential recommended values.

Project description:Background: The incidence of twin pregnancies has risen recently. Such pregnancies are associated with an increased risk for poor maternal and infant outcomes. Gestational weight gain, particularly in singleton pregnancies, has been well-linked with maternal and infant outcomes. The aim of the current meta-analysis was to evaluate the effects of gestational weight gain on maternal and fetal outcomes in women with twin pregnancies. Methods: A systematic search was conducted using the PubMed, Scopus, and Google Scholar databases. Studies, either retrospective or prospective in design, evaluating the effects of gestational weight gain (defined using Institute of Medicine (IOM) guidelines) maternal and/or fetal/neonatal outcomes in women with twin pregnancies were included. Statistical analysis was performed using STATA software. Results: Eleven studies were included in the meta-analysis. Mothers with inadequate weight gain had increased risk for gestational diabetes mellitus (OR 1.19; 95% CI: 1.01, 1.40) and decreased risk for gestational hypertension (OR 0.58; 95% CI: 0.49, 0.68) and cesarean section (OR 0.94; 95% CI: 0.93, 0.96). Neonates born to mothers with inadequate weight gain were susceptible to increased risk for preterm delivery (OR 1.17; 95% CI: 1.03, 1.34), very preterm delivery (gestational age <32 weeks) (OR 1.84; 95% CI: 1.36, 2.48), small for gestational age status (OR 1.41; 95% CI: 1.15, 1.72), low birth weight status (<2,500 g) (OR 1.27; 95% CI: 1.17, 1.38), and neonatal intensive care unit (NICU) admission (OR 1.16; 95% CI: 1.08, 1.24). The pooled findings indicate an increased risk for gestational hypertension (OR 1.82; 95% CI: 1.60, 2.06) and cesarean section (OR 1.07; 95% CI: 1.05, 1.08) among mothers with excessive weight gain. Neonates born to mothers with excessive weight gain were susceptible to increased risk for preterm delivery and very preterm delivery, but were associated with a decreased risk for low birth weight status and small for gestational age status. Conclusions: Gestational weight gain in twin pregnancy, either lower or higher than IOM recommended guidelines, is associated with poor maternal and neonatal outcomes. Our findings call for incorporating counseling on optimal weight gain during pregnancy as part of routine antenatal visits.

Project description:BACKGROUND:Gestational diabetes mellitus (GDM) is correlated with an increased risk of adverse perinatal outcomes for both the mother and offspring. Previous research has reported correlations between maternal dietary patterns and GDM, but such evidence for twin pregnancies is lacking. This study aimed to identify maternal dietary patterns in the second trimester and investigate their relationships with the risk of GDM among women who were pregnant with twins in China. METHODS:A longitudinal twin pregnancies birth cohort study of women who were pregnant with twins in China was conducted. Maternal dietary intake in the second trimester was recorded by using a food frequency questionnaire prior to the diagnosis of GDM among participants from the prospective twin pregnancies birth cohort in Chongqing City. GDM was diagnosed with a 75?g 2-h oral glucose tolerance test at 23-26?weeks of gestation. Dietary patterns were identified by principal components analysis, and the correlations between dietary pattern and GDM were examined using multivariable logistic regression analyses. RESULTS:Of the 324 participants, 101 (31.2%) were diagnosed with GDM. Four dietary patterns were identified: a vegetable-based pattern, a poultry-and-fruit-based pattern, a sweet-based pattern and a plant-protein-based pattern. Multivariate analysis showed that none of the dietary patterns were correlated with the risk of GDM among women who were pregnant with twins, but the sweet-based dietary pattern, which was associated with a higher GDM risk for quartile 4 versus quartile 1 (OR 2.69; 95% CI: 1.09, 6.66) among non-overweight women (prepregnancy BMI?<?24.0). CONCLUSION:Dietary patterns were not correlated with later GDM risk among women who were pregnant with twins in western China, whereas a high intake of sweets was associated with a higher risk for GDM among women who were not overweight prior to pregnancy. TRIAL REGISTRATION:ChiCTR-OOC-16008203. Retrospectively registered on 1 April 2016.

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Gestational weight gain charts for twin pregnancies in Southeast China.

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Gestational weight gain charts for twin pregnancies in Southeast China.

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