Maternal and neonatal outcomes according to gestational weight gain in twin pregnancies: Are the Institute of Medicine guidelines associated with better outcomes?

Abstract Objective The Institute of Medicine (IOM) recommended a gestational weight gainfor full-term twin pregnancies of 17–25 kg for normal Body mass Index patients’, and characterize its guidelines on during twin pregnancies as “provisional”. Indeed, they are exclusively based on observational epidemiological data. The objective of this study was to investigate whether the IOM’s gestational weight gainguidelines are optimal for maternal and neonatal. Outcomes study design We included all consecutive twin pregnancies delivering two live births retrospectively. Monoamniotic pregnancies, major congenital abnormalities, twin-to- twin transfusion syndrome, patients with missing gestational weight gaindata in the last month before delivery, and patients with a body mass index (BMI) ≤18.5 were excluded. To control for gestationallength, we divided the total weight gainby the gestationalage in weeks at the last weightmeasurement to obtain the weight gainper week. Patients were classified as having low gestational weight gain, adequate gestational weight gain, or excessive gestational weight gain, with the results adjusted for BMI and tobacco use. Results There were 878 patients in our level-III university hospital maternity ward who met the inclusion criteria in 1997–2013. Excessive gestational weight gainwomen had greater rates of preeclampsia than adequate gestational weight gainwomen did. Low gestational weight gainwomen showed a lower rate of gestational hypertensionthan AGWG women did. Delivery before 37 weeks of gestation(26.9% vs. 17.3%, p = 0.009), birth weightConclusion Adequate gestational weight gainwas associated with better outcomes. Our results suggest that the IOM guidelines for twin pregnancy are appropriate and therefore should be routinely used.