Stefanie N Hinkle1, Mary L Hediger2, Sungduk Kim3, Paul S Albert3, William Grobman4, Roger B Newman5, Deborah A Wing6,7, Jagteshwar Grewal2, Cuilin Zhang8, Germaine M Buck Louis2, Katherine L Grantz8. 1. Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD; hinklesn@mail.nih.gov. 2. Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD. 3. Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD. 4. Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL. 5. Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC. 6. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, School of Medicine, University of California, Irvine, Orange, CA; and. 7. Division of Maternal Fetal Medicine, Miller Children's and Women's Hospital Long Beach and Long Beach Memorial Medical Center, Long Beach, CA. 8. Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
Abstract
Background: Maternal metabolic demands are much greater with twin gestations; however, there are no accepted recommendations for maternal weight gain in twin pregnancies.Objective: We assessed the association of maternal weight gain and fetal growth in dichorionic twins throughout pregnancy.Design: This was a prospective US cohort study (n = 143, 2012-2013) of dichorionic twin pregnancies with known birth outcomes followed from enrollment (11-13 wk) and for ≤6 research visits throughout gestation. Maternal prepregnancy weight was self-reported, and current weight was measured at each research visit and abstracted from prenatal records. Fetal biometry was assessed by ultrasound at each research visit. Maternal weight and twin-pair fetal size trajectories across gestation were modeled. The adjusted associations between maternal weight gain from 0 to 13, 14 to 20, 21 to 27, and 28 to 34 wk and fetal growth at the subsequent week (i.e., 14, 21, 28, and 35 wk, respectively) were estimated with the use of linear regression. Results: The mean ± SD maternal weight gain from 0 to 13, 14 to 20, 21 to 27, and 28 to 34 wk was 2.8 ± 3.0 kg, 3.9 ± 1.2 kg, 3.8 ± 1.4 kg, and 4.4 ± 2.2 kg, respectively, with a total gain of 17.7 ± 7.4 kg. Maternal weight gain from 0 to 13 wk (first trimester) was not associated with fetal size at 14 wk. Maternal weight gain from 14 to 20 and 21 to 27 wk (second trimester) was significantly associated with increased fetal weight at 21 wk [increase of 10.5 g/kg maternal weight gain (95% CI: 1.2, 19.8 g)] and 28 wk [increase of 21.3 g/kg maternal weight gain (95% CI: 0.6, 42.0 g)]. Maternal weight gain from 14 to 20 wk was associated with increased twin abdominal circumference (AC) and biparietal diameter at 21 wk. Maternal weight gain from 21 to 27 wk was associated with increased femur and humerus lengths at 28 wk. Conclusion: Maternal weight gain was associated with dichorionic twin fetal growth in the second trimester only, driven by an association with AC earlier in second trimester and long bones later in the second trimester.
Background: Maternal metabolic demands are much greater with twin gestations; however, there are no accepted recommendations for maternal weight gain in twin pregnancies.Objective: We assessed the association of maternal weight gain and fetal growth in dichorionic twins throughout pregnancy.Design: This was a prospective US cohort study (n = 143, 2012-2013) of dichorionic twin pregnancies with known birth outcomes followed from enrollment (11-13 wk) and for ≤6 research visits throughout gestation. Maternal prepregnancy weight was self-reported, and current weight was measured at each research visit and abstracted from prenatal records. Fetal biometry was assessed by ultrasound at each research visit. Maternal weight and twin-pair fetal size trajectories across gestation were modeled. The adjusted associations between maternal weight gain from 0 to 13, 14 to 20, 21 to 27, and 28 to 34 wk and fetal growth at the subsequent week (i.e., 14, 21, 28, and 35 wk, respectively) were estimated with the use of linear regression. Results: The mean ± SD maternal weight gain from 0 to 13, 14 to 20, 21 to 27, and 28 to 34 wk was 2.8 ± 3.0 kg, 3.9 ± 1.2 kg, 3.8 ± 1.4 kg, and 4.4 ± 2.2 kg, respectively, with a total gain of 17.7 ± 7.4 kg. Maternal weight gain from 0 to 13 wk (first trimester) was not associated with fetal size at 14 wk. Maternal weight gain from 14 to 20 and 21 to 27 wk (second trimester) was significantly associated with increased fetal weight at 21 wk [increase of 10.5 g/kg maternal weight gain (95% CI: 1.2, 19.8 g)] and 28 wk [increase of 21.3 g/kg maternal weight gain (95% CI: 0.6, 42.0 g)]. Maternal weight gain from 14 to 20 wk was associated with increased twin abdominal circumference (AC) and biparietal diameter at 21 wk. Maternal weight gain from 21 to 27 wk was associated with increased femur and humerus lengths at 28 wk. Conclusion:Maternal weight gain was associated with dichorionic twin fetal growth in the second trimester only, driven by an association with AC earlier in second trimester and long bones later in the second trimester.
Authors: Victor H González-Quintero; Anupama S Q Kathiresan; Felipe José Tudela; Debbie Rhea; Cheryl Desch; Niki Istwan Journal: Am J Perinatol Date: 2012-03-07 Impact factor: 1.862
Authors: Germaine M Buck Louis; Jagteshwar Grewal; Paul S Albert; Anthony Sciscione; Deborah A Wing; William A Grobman; Roger B Newman; Ronald Wapner; Mary E D'Alton; Daniel Skupski; Michael P Nageotte; Angela C Ranzini; John Owen; Edward K Chien; Sabrina Craigo; Mary L Hediger; Sungduk Kim; Cuilin Zhang; Katherine L Grantz Journal: Am J Obstet Gynecol Date: 2015-10 Impact factor: 8.661
Authors: Katherine L Grantz; Jagteshwar Grewal; Paul S Albert; Ronald Wapner; Mary E D'Alton; Anthony Sciscione; William A Grobman; Deborah A Wing; John Owen; Roger B Newman; Edward K Chien; Robert E Gore-Langton; Sungduk Kim; Cuilin Zhang; Germaine M Buck Louis; Mary L Hediger Journal: Am J Obstet Gynecol Date: 2016-04-30 Impact factor: 8.661
Authors: Sisi Li; Yuhan Qiu; Xi Yuan; Qin Zhang; Mark D Kilby; Richard Saffery; Philip N Baker; Li Wen; Chao Tong; Hongbo Qi Journal: Front Pediatr Date: 2022-08-02 Impact factor: 3.569