Maternal weight gain and associations with longitudinal fetal growth in dichorionic twin pregnancies: A prospective cohort study

Stefanie N. Hinkle*, Mary L. Hediger, Sungduk Kim, Paul S. Albert, William Grobman, Roger B. Newman, Deborah A. Wing, Jagteshwar Grewal, Cuilin Zhang, Germaine M. Buck Louis, Katherine L. Grantz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

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 6 SD maternal weight gain from 0 to 13, 14 to 20, 21 to 27, and 28 to 34 wk was 2.8 6 3.0 kg, 3.9 6 1.2 kg, 3.8 6 1.4 kg, and 4.4 6 2.2 kg, respectively, with a total gain of 17.7 6 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.

Original languageEnglish (US)
Pages (from-to)1449-1455
Number of pages7
JournalAmerican Journal of Clinical Nutrition
Volume106
Issue number6
DOIs
StatePublished - Dec 1 2017

Funding

Supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH (contracts HHSN275200800013C, HHSN275200800002I, HHSN27500006, HHSN275200800003IC, HHSN275200800014C, HHSN275200800012C, HHSN275200800028C, and HHSN275201000009C).

Keywords

  • Birth weight
  • Fetal growth
  • Pregnancy
  • Twins
  • Weight gain

ASJC Scopus subject areas

  • Nutrition and Dietetics
  • Medicine (miscellaneous)

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