Author:
Dimitris Michelle C,Hutcheon Jennifer A,Platt Robert W,Abrahamowicz Michal,Beauchamp Marie-Eve,Himes Katherine P,Bodnar Lisa M,Kaufman Jay S
Abstract
Abstract
Both inadequate and excessive maternal weight gain are correlated with preterm delivery in singleton pregnancies, yet this relationship has not been adequately studied in twins. We investigated the relationship between time-varying maternal weight gain and gestational age at delivery in twin pregnancies and compared it with that in singletons delivered in the same study population. We used serial weight measurements abstracted from charts for twin and singleton pregnancies delivered during 1998–2013 in Pittsburgh, Pennsylvania. Our exposure was time-varying weight gain z score, calculated using gestational age–standardized and prepregnancy body mass index–stratified twin- and singleton-specific charts, and our outcome was gestational age at delivery. Our analyses used a flexible extension of the Cox proportional hazards model that allowed for nonlinear and time-dependent effects. We found a U-shaped relationship between weight gain z score and gestational age at delivery among twin pregnancies (lowest hazard of delivery observed at z score = 1.2), which we attributed to increased hazard of early preterm spontaneous delivery among pregnancies with low weight gain and increased hazard of late preterm delivery without labor among pregnancies with high weight gain. Our findings may be useful for updating provisional guidelines for maternal weight gain in twin pregnancies.
Publisher
Oxford University Press (OUP)
Reference42 articles.
1. Diet or exercise, or both, for preventing excessive weight gain in pregnancy;Muktabhant;Cochrane Database Syst Rev.,2015
2. Severe obesity, gestational weight gain, and adverse birth outcomes;Bodnar;Am J Clin Nutr.,2010
3. Association of maternal gestational weight gain with short- and long-term maternal and child health outcomes;Margerison Zilko;Am J Obstet Gynecol.,2010
4. Patterns of gestational weight gain in early pregnancy and risk of gestational diabetes mellitus;MacDonald;Epidemiology.,2017
5. Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta-analysis of European, North American, and Australian cohorts;Santos;BJOG.,2019