From Maternal-Fetal Medicine Associates, PLLC, and the Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, New York.
Obstet Gynecol. 2010 Jul;116(1):100-106. doi: 10.1097/AOG.0b013e3181e24afc.
To estimate whether the weight gain recommendations for twin pregnancies in the 2009 Institute of Medicine (IOM) guidelines are associated with improved perinatal outcomes.
A cohort of 297 twin pregnancies was identified from a single practice with measured prepregnancy body mass index (BMI) and weight gain during pregnancy. Recommended IOM guidelines were applied to our cohort based on prepregnancy BMI categories (normal weight, overweight, obese). Pregnancy outcomes were compared between patients whose weight gain met or exceeded the IOM recommendations and patients who did not meet these recommendations.
Patients with normal prepregnancy BMIs whose weight gain met the IOM recommendations had significantly improved outcomes compared with patients who did not meet the IOM recommendations. They were less likely to have preterm birth before 32 weeks (5.0% compared with 13.8%) and spontaneous preterm birth before 32 weeks (3.4% compared with 11.5%). They also delivered significantly larger neontates (larger twin birth weight 2,582.1+/-493.4 g compared with 2,370.3+/-586.0 g; smaller twin birth weight 2,277.0+/-512.1 g compared with 2,109.3+/-560.9 g) and were significantly more likely to have both neonates weigh more than 2,500 g (38.8% compared with 22.5%) and more than 1,000 g (97.5% compared with 91.2%) and were less likely to deliver any twin with a birth weight lower than the fifth percentile for gestational age (21.5% compared with 35.0%).
In women with twin pregnancies and normal starting BMIs, weight gain during pregnancy is significantly associated with improved outcomes, including a decreased risk of prematurity and larger birth weights.
II.
评估 2009 年美国医学研究所（IOM）指南中关于双胞胎妊娠增重建议是否与改善围产期结局相关。
从一家单家诊所中确定了 297 例双胎妊娠病例，这些患者均有孕前体重指数（BMI）和孕期体重增加的测量值。根据孕前 BMI 类别（正常体重、超重、肥胖），将推荐的 IOM 指南应用于我们的队列。将符合或超过 IOM 建议的患者与不符合这些建议的患者的妊娠结局进行比较。
孕前 BMI 正常且符合 IOM 建议的患者的妊娠结局明显优于不符合 IOM 建议的患者。他们发生早产（32 周前）的可能性较低（5.0% 比 13.8%），自发性早产（32 周前）的可能性也较低（3.4% 比 11.5%）。他们还分娩出了明显较大的新生儿（较大的双胞胎出生体重 2582.1±493.4g 比 2370.3±586.0g；较小的双胞胎出生体重 2277.0±512.1g 比 2109.3±560.9g），并且更有可能使两个新生儿的体重都超过 2500g（38.8% 比 22.5%）和 1000g（97.5% 比 91.2%），并且使分娩的任何双胞胎的出生体重低于胎龄第 5 百分位数的可能性较小（21.5% 比 35.0%）。
在孕前 BMI 正常的双胎妊娠妇女中，孕期体重增加与改善结局显著相关，包括降低早产风险和增加出生体重。
II。
