Journal List > Korean J Obstet Gynecol > v.53(8) > 1006451

Lee, Kim, Kwon, and Park: Pregnancy outcome according to gestational weight gain in twin pregnancies on the basis of the 2009 Institute of Medicine (IOM) recommendations



The aim of this study was to investigate the effect of gestational weight gain on pregnancy outcome in twin pregnancies according to prepregnancy body mass index (BMI), on the basis of 2009 Institute of Medicine (IOM) recommendations.


One hundred ninety-eight twin pregnancy women and their 396 neonates who delivered in Yonsei University Health System from January 1st, 2005 to April 30th, 2010. Maternal height, maternal weight in prepregnancy and gestational weight gain were retrospectively reviewed. Women were grouped into four categories of BMI: underweight (<18.5 kg/m2), normal weight (18.5~24.9 kg/m2), overweight (25~29.9 kg/m2) and obese (≥30 kg/m2). Gestational weight gain was categorized as "Less" if it was below the IOM's recommended range for the woman's prepregnancy BMI, "Within" if it was within the range, and "More" if it was above the range.


Underweight with "Less" or "Within" maternal weight gain groups were associated with significantly increased odds for small for gestational age ("Less", odds ratio [OR] 6.5, confidence interval [CI] 1.75~24.14; "Within", OR 3.55, CI 1.37~9.14) and "More" weight gain with overweight or obesity groups were associated with significantly increased odds for large for gestational age (overweight, OR 6.25, CI 1.14~34.32; obesity, OR 8.33, CI 1.14~47.93). Overweight or obese women and excessive gestational weight gain were associated with significantly increased odds of pregnancy induced hypertension (overweight: OR 7.04, CI 1.04~47.78, obesity: OR 10.56, CI 1.32~84.14) and gestational diabetes mellitus (overweight: OR 13.2, CI 1.78~97.74, obesity: OR 19.8, CI 2.29~171.02).


Overweight or obese women with excessive gestational weight gain were associated with significantly increased risk of adverse pregnancy outcome in twin pregnancies. Therefore, physician should pay attention not only to prepregnancy BMI but also to maternal weight gain. A large prospective study is necessary to confirm the relationships between gestational weight gain and pregnancy outcome in twin pregnancies.

Figures and Tables

Table 1
Maternal characteristics and complications

IOM: Institute of Medicine, BMI: body mass index, PIH: pregnancy induced hypertension, GDM: gestational diabetes mellitus.

Table 2
Neonatal outcomes based on maternal prepregnancy body mass index (BMI) categories

SGA: small for gestational age, LGA: large for gestational age, NICU: neonatal intensive care unit.

Table 3
Multiple linear regression analysis of neonatal outcomes


Table 4
Multivariate logistic regression of maternal and neonatal outcomes

SGA: small for gestational age, LGA: large for gestational age, NICU: neonatal intensive care unit, PIH: pregnancy induced hypertension, GDM: gestational diabetes mellitus.



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