Pécheux O, Garabedian C, Mizrahi S, Cordiez S, Deltombe S, Deruelle P
EA4489 environnement périnatal et santé, université Lille 2, CHRU de Lille, 59000 Lille, France.
EA4489 environnement périnatal et santé, université Lille 2, CHRU de Lille, 59000 Lille, France.
Gynecol Obstet Fertil Senol. 2017 Jun;45(6):366-372. doi: 10.1016/j.gofs.2017.02.003. Epub 2017 Mar 31.
Our objective was to evaluate the relevance of the Institute of medicine (IOM) guidelines of weight gain during twin pregnancies, published in 2009.
We systematically reviewed the data from Medline and the Cochrane Library databases. We only selected the articles which studied the neonatal and maternal outcomes according to maternal gestational weight gain (GWG), depending on the prepregnancy BMI (body mass index). Five clinical parameters had been mainly studied: gestational hypertensive disorders (gestational hypertension and preeclampsia), gestational diabetes mellitus (GDM), preterm births, and birth weights.
We identified 8 articles, corresponding to our inclusion criteria. They all present methodological weaknesses (observational retrospective design, small population samples and there were sometimes issues to properly determine the GWG). An excessive weight gain was associated with an increasing of gestational hypertensive disorders. Regarding GDM, the results were inconsistent, suggesting a poor correlation between GWG and occurrence of GDM. Preterm births and low birth weights were more frequent when the GWG did not reach the recommendations.
Although based on low scientific evidence, the IOM recommendations for GWG in twin pregnancies should be used in daily practice.
我们的目的是评估2009年发布的美国医学研究所（IOM）关于双胎妊娠体重增加的指南的相关性。
我们系统地回顾了来自Medline和Cochrane图书馆数据库的数据。我们仅选择了那些根据孕妇孕期体重增加（GWG）、依据孕前体重指数（BMI）研究新生儿和母亲结局的文章。主要研究了五个临床参数：妊娠期高血压疾病（妊娠高血压和子痫前期）、妊娠期糖尿病（GDM）、早产和出生体重。
我们确定了8篇符合我们纳入标准的文章。它们都存在方法学上的弱点（观察性回顾性设计、样本量小，并且有时在准确确定GWG方面存在问题）。体重过度增加与妊娠期高血压疾病的增加有关。关于GDM，结果不一致，表明GWG与GDM的发生之间相关性较差。当GWG未达到建议值时，早产和低出生体重更为常见。
尽管基于低科学证据，但IOM关于双胎妊娠GWG的建议仍应用于日常实践。
