Choi Bo Young, Hong Subeen, Jeon Minhee, Park Jee Yoon, Oh Kyung Joon, Hong Joon-Seok
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Obstet Gynecol Sci. 2020 Nov;63(6):690-699. doi: 10.5468/ogs.20133. Epub 2020 Nov 3.
To investigate the effect of gestational weight gain (GWG) on maternal and neonatal outcomes based on the Institute of Medicine (IOM) guidelines for twin pregnancies.
This study included women with twin pregnancies who delivered at Seoul National University Bundang Hospital. Based on the weight gain per gestational week according to the 2009 IOM guidelines, the subjects were divided into the following 3 groups: inadequate, adequate, and excessive GWG. We compared the maternal and neonatal outcomes of each group.
A total of 1,738 twin pregnancies were included in our study. Of these cases, 881, 694, and 163 (50.7%, 39.9%, and 9.4%, respectively) twin pregnancies were categorized into the inadequate, adequate, and excessive GWG groups, respectively. In the inadequate GWG group, the risks of preterm birth <34 weeks (aOR, 2.33, 95% confidence interval [CI], 1.63-3.34) and delivering neonates who were small for gestational age (aOR, 1.92, 95% CI, 1.42-2.60) were increased, and the risk of preeclampsia (aOR, 0.49, 95% CI, 0.32-0.76) was decreased. The excessive GWG group had an increased risk of the neonates being large for gestational age (aOR, 1.79, 95% CI, 1.15-2.81).
The 2009 IOM recommendations for GWG can be applied to Korean women with twin pregnancies to help achieve optimal maternal and neonatal outcomes. However, more than half of the women were categorized as having inadequate weight gain according to the guidelines. Further studies should be performed to obtain Korean national references for GWG in twin pregnancies.
根据美国医学研究所（IOM）关于双胎妊娠的指南，探讨孕期体重增加（GWG）对母婴结局的影响。
本研究纳入在首尔国立大学盆唐医院分娩的双胎妊娠女性。根据2009年IOM指南中每周的体重增加情况，将研究对象分为以下三组：GWG不足、充足和过多。我们比较了每组的母婴结局。
本研究共纳入1738例双胎妊娠。其中，分别有881例、694例和163例（分别占50.7%、39.9%和9.4%）双胎妊娠被归类为GWG不足、充足和过多组。在GWG不足组中，<34周早产（调整后比值比[aOR]，2.33，95%置信区间[CI]，1.63 - 3.34）和分娩小于胎龄儿（aOR，1.92，95% CI，1.42 - 2.60）的风险增加，而子痫前期风险（aOR，0.49，95% CI，0.32 - 0.76）降低。GWG过多组中，新生儿大于胎龄的风险增加（aOR，1.79，95% CI，1.15 - 2.81）。
2009年IOM关于GWG的建议可应用于韩国双胎妊娠女性，以帮助实现最佳母婴结局。然而，根据指南，超过一半的女性被归类为体重增加不足。应进一步开展研究以获取韩国双胎妊娠GWG的全国参考标准。
