Hutcheon Jennifer A, Platt Robert W, Abrams Barbara, Braxter Betty J, Eckhardt Cara L, Himes Katherine P, Bodnar Lisa M
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada.
Departments of Pediatrics and of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada.
Paediatr Perinat Epidemiol. 2018 Mar;32(2):172-180. doi: 10.1111/ppe.12446. Epub 2018 Jan 29.
Twin pregnancies are at increased risk for adverse outcomes and are associated with greater gestational weight gain compared to singleton pregnancies. Studies that disentangle the relationship between gestational duration, weight gain and adverse outcomes are needed to inform weight gain guidelines. We created charts of the mean, standard deviation and select percentiles of maternal weight gain-for-gestational age in twin pregnancies and compared them to singleton curves.
We abstracted serial prenatal weight measurements of women delivering uncomplicated twin pregnancies at Magee-Womens Hospital (Pittsburgh, PA, 1998-2013) and merged them with the hospital's perinatal database. Hierarchical linear regression was used to express pregnancy weight gain as a smoothed function of gestational age according to pre-pregnancy BMI category. Charts of week- and day-specific values for the mean, standard deviation, and percentiles of maternal weight gain were created.
Prenatal weight measurements (median: 11 [interquartile range: 9, 13] per woman) were available for 1109 women (573 normal weight, 287 overweight, and 249 obese). The slope of weight gain was most pronounced in normal weight women and flattened with increasing pre-pregnancy BMI (e.g. 50th percentiles of 6.8, 5.7, and 3.6 kg at 20 weeks and 19.8, 18.1, and 14.4 at 37 weeks in normal weight, overweight, and obese women, respectively). Weight gain patterns in twins diverged from singletons after 17-19 weeks.
Our charts provide a tool for the classification of maternal weight gain in twin pregnancies. Future work is needed to identify the range of weight gain associated with optimal pregnancy health outcomes.
与单胎妊娠相比，双胎妊娠出现不良结局的风险增加，且孕期体重增加更多。需要开展研究来厘清孕周、体重增加与不良结局之间的关系，以为体重增加指南提供依据。我们绘制了双胎妊娠中按孕周计算的孕妇体重增加的均值、标准差及选定百分位数的图表，并将其与单胎曲线进行比较。
我们提取了在梅杰妇女医院（宾夕法尼亚州匹兹堡，1998 - 2013年）分娩的无并发症双胎妊娠女性的系列产前体重测量数据，并将其与该医院的围产期数据库合并。根据孕前BMI类别，采用分层线性回归将孕期体重增加表示为孕周的平滑函数。创建了按周和天划分的孕妇体重增加均值、标准差及百分位数的特定值图表。
1109名女性（573名体重正常、287名超重、249名肥胖）有产前体重测量数据（中位数：每名女性11次[四分位间距：9, 13]）。体重增加斜率在体重正常的女性中最为明显，且随着孕前BMI的增加而变平（例如，体重正常、超重和肥胖女性在孕20周时第50百分位数分别为6.8、5.7和3.6千克，在孕37周时分别为19.8、18.1和14.4千克）。双胎妊娠的体重增加模式在17 - 19周后与单胎妊娠有所不同。
我们的图表为双胎妊娠孕妇体重增加的分类提供了一种工具。未来需要开展工作来确定与最佳妊娠健康结局相关的体重增加范围。
