[Maternal and neonatal outcomes according to gestational weight gain in twin pregnancies: Are the IOM guidelines associated with better issues?].

OBJECTIVE

Our objective was to evaluate the relevance of the Institute of medicine (IOM) guidelines of weight gain during twin pregnancies, published in 2009.

METHODS

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.

RESULTS

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.

CONCLUSION

Although based on low scientific evidence, the IOM recommendations for GWG in twin pregnancies should be used in daily practice.