Dinu Monica, Napoletano Antonia, Giangrandi Ilaria, Lotti Sofia, Ruotolo Agostino, Renda Irene, Nardone Luca, Paternò Irene, Seravalli Viola, Tristan Asensi Marta, Pagliai Giuditta, Colombini Barbara, Di Tommaso Mariarosaria, Sofi Francesco
Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy.
Nutr Metab (Lond). 2024 Dec 2;21(1):99. doi: 10.1186/s12986-024-00881-1.
Twin pregnancies present unique challenges in maternal healthcare. However, current guidelines primarily address singleton pregnancies, resulting in a knowledge gap regarding their specific metabolic and dietary needs. This study aimed to follow women with twin pregnancies through all three trimesters, assessing basal metabolic rate (BMR), dietary intake, and diet quality.
A two-year prospective observational study was conducted at AOU Careggi Hospital, Florence, Italy, involving 35 twin-pregnant women, with 32 completing the study. Participants underwent calorimetric, anthropometric, and dietary assessments during the first (8-13 weeks), second (14-27 weeks), and third trimesters (28-34 weeks). BMR was measured using indirect calorimetry and compared with predictive equations. Dietary intake was evaluated using 7-day food diaries and the Medi-Lite adherence score.
Indirect calorimetry revealed an increase in BMR by 16%, rising from 1479 ± 196 kcal in the first trimester to 1733 ± 224 kcal in the third trimester. Hronek's equation, previously validated for singleton pregnancies, was identified as the most accurate predictive tool for estimating BMR. Dietary analysis revealed that mean daily energy intake increased from 1660 ± 244 kcal in the first trimester to 1889 ± 262 kcal in the third trimester, consistently below recommendations, with insufficient macro- and micronutrient consumption. Poor diet quality was characterized by low intake of fruits, vegetables, legumes, and fresh fish, and high consumption of processed meats, cheese, and sugar-sweetened beverages. Adherence to the Mediterranean diet was moderate across all three trimesters.
This study highlights the increased energy demands and nutritional inadequacies in twin pregnancies, underscoring the need for tailored dietary guidelines and interventions.
双胎妊娠在孕产妇保健方面带来了独特的挑战。然而，目前的指南主要针对单胎妊娠，导致在双胎妊娠特定的代谢和饮食需求方面存在知识空白。本研究旨在对双胎妊娠女性进行整个孕期的跟踪，评估基础代谢率（BMR）、饮食摄入量和饮食质量。
在意大利佛罗伦萨的阿OU卡雷吉医院进行了一项为期两年的前瞻性观察研究，纳入35例双胎妊娠女性，其中32例完成了研究。参与者在孕早期（8 - 13周）、孕中期（14 - 27周）和孕晚期（28 - 34周）接受了热量测定、人体测量和饮食评估。使用间接热量测定法测量基础代谢率，并与预测方程进行比较。通过7天食物日记和Medi-Lite依从性评分评估饮食摄入量。
间接热量测定显示基础代谢率增加了16%，从孕早期的1479±196千卡升至孕晚期的1733±224千卡。先前已在单胎妊娠中验证的赫罗内克方程被确定为估计基础代谢率最准确的预测工具。饮食分析显示，平均每日能量摄入量从孕早期的1660±244千卡增加到孕晚期的1889±262千卡，始终低于推荐量，宏量营养素和微量营养素摄入不足。饮食质量差的特点是水果、蔬菜、豆类和新鲜鱼类摄入量低，加工肉类、奶酪和含糖饮料消费量高。在所有三个孕期中，对地中海饮食的依从性适中。
本研究强调了双胎妊娠中能量需求增加和营养不足的情况，突出了制定针对性饮食指南和干预措施的必要性。
