Optimal Gestational Weight Gain in Chinese Women with Twin Pregnancy

Abstract

Objectives: To propose an optimal gestational weight gain (GWG) guideline for Chinese women with twin pregnancy and to assess the neonatal and maternal outcomes based on the proposed guideline.
Methods: Records of women who delivered dichorionic diamniotic twins after 24 weeks of gestation at Tuen Mun Hospital between 2012 and 2016 were retrospectively reviewed. They were classified according to their pre-pregnancy body mass index (BMI) as underweight/normal weight or overweight/obese. An optimal GWG was proposed for each group by deriving the interquartile range of GWG in women who delivered twins with a birthweight of ≥2500 g at 37-
42 weeks of gestation. Women were categorised as having GWG below, between, or above the proposed standard. Maternal characteristics and neonatal and maternal outcomes of the three GWG categories were compared.
Results: A total of 171 women were identified. Of them, 25 were underweight, 100 normal weight, 18 overweight, and 28 obese, according to the Asian BMI classification. Only 48 of 171 women delivered twins with a mean birthweight of ≥2500 g at 37-42 weeks of gestation. Respectively in underweight/normal weight and overweight/obese women with twin pregnancy, a GWG of 15.15 to 23.90 kg (0.41-0.65 kg per week) and 13.10 to 17.30 kg (0.35-0.47 kg per week) was proposed. In underweight/normal weight women, those with GWG below the standard had significantly
increased odds of spontaneous preterm labour, one or both twins with a birthweight of <1500 g, one or both twins with a birthweight of <2500 g, delivery at ≤34 weeks, and any twin requiring neonatal intensive care unit admission.
Conclusion: In underweight/normal weight Chinese women with twin pregnancy, those with a GWG below 15.15 kg had increased risks of giving birth to low or very low birthweight babies, spontaneous preterm labour, and delivery at ≤34 weeks.