From the Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and Medical University of South Carolina, Charleston, South Carolina.
Obstet Gynecol. 2009 Nov;114(5):1121-1134. doi: 10.1097/AOG.0b013e3181bb14c8.
Twin pregnancies contribute a disproportionate degree to perinatal morbidity, partly because of increased risks of low birth weight and prematurity. Although the cause of the morbidity is multifactorial, attention to twin-specific maternal nutrition may be beneficial in achieving optimal fetal growth and birth weight. Achievement of body mass index (BMI)-specific weight gain goals, micronutrient and macronutrient supplementation specific to the physiology of twin gestations, and carbohydrate-controlled diets are recommended for optimal twin growth and pregnancy outcomes. The daily recommended caloric intake for normal-BMI women with twins is 40-45 kcal/kg each day, and iron, folate, calcium, magnesium, and zinc supplementation is recommended beyond a usual prenatal vitamin. Daily supplementation of docosahexaenoic acid and vitamin D should also be considered. Multiple gestation-specific prenatal care settings with a focus on nutritional interventions improve birth weight and length of gestation and should be considered for the care of women carrying multiples. Antepartum lactation consultation can also improve the rate of postpartum breastfeeding in twin pregnancies. Twin gestation-specific nutritional interventions seem effective in improving the outcome of these pregnancies and should be emphasized in the antepartum care of multiple gestations. This review examines the available evidence and offers recommendations for twin pregnancy-specific nutritional interventions.
双胎妊娠导致围产期发病率不成比例地升高，部分原因是低出生体重和早产的风险增加。尽管发病原因是多因素的，但关注双胎特有的母体营养可能有助于实现最佳胎儿生长和出生体重。实现体重指数 (BMI) 特定的体重增加目标、针对双胎妊娠生理的微量营养素和宏量营养素补充以及碳水化合物控制饮食，被推荐用于最佳的双胎生长和妊娠结局。对于 BMI 正常的双胎妊娠妇女，每日推荐的热量摄入量为 40-45kcal/kg，并且建议在常规产前维生素之外补充铁、叶酸、钙、镁和锌。还应考虑每日补充二十二碳六烯酸和维生素 D。关注营养干预的多胎妊娠特定的产前保健环境可以改善出生体重和妊娠期，并应考虑用于多胎妊娠的护理。产前哺乳咨询也可以提高双胎妊娠产后母乳喂养的比例。双胎妊娠特有的营养干预措施似乎可以有效改善这些妊娠的结局，应该在多胎妊娠的产前保健中得到强调。这篇综述检查了现有的证据，并为双胎妊娠特有的营养干预措施提供了建议。
