{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T20:59:23Z","timestamp":1771621163076,"version":"3.50.1"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003Adequate maternal weight gain in twin pregnancies is associated with improved outcomes such as increased fetal growth and decreased incidence of preterm birth. However, it remains unclear when gestational weight gain has the greatest influence on pregnancy outcomes. Our objective was to identify at which time in a twin pregnancy does inadequate maternal weight gain have the greatest association with adverse pregnancy outcomes.<\/jats:p><jats:p>\n          Study Design\u2003This is a retrospective cohort study of women with twin pregnancies and normal prepregnancy body mass index (BMI, 18.5\u201324.9\u2009kg\/m2) who delivered at \u226524 weeks' gestation by a single maternal\u2013fetal medicine practice between 2005 and 2017. Baseline characteristics and pregnancy outcomes were compared between women with and without adequate average gestational weight gain (weight gain per week based on the 2009 Institute of Medicine recommendations). This analysis was performed for weight gain over the entire pregnancy, as well as from 0 to 16, 16 to 24, and 24 weeks to delivery. Multivariable regression analysis was performed to control for potential confounding variables.<\/jats:p><jats:p>\n          Results\u2003A total of 609 women with twin pregnancies and normal prepregnancy BMI were included, of whom 386 (63.4%) had adequate average gestational weight gain over the entire pregnancy and 223 (36.6%) did not. Inadequate average gestational weight gain between 0 and 16 weeks' gestation was associated with a higher incidence of birthweight less than the 10th percentile for gestational age (adjusted odds ratio [aOR]: 1.67; 95% confidence interval [CI]: 1.11\u20132.51) and less than the 5th percentile for gestational age (aOR: 2.10; 95% CI: 1.29\u20133.40). Inadequate gestational weight gain between 16 and 24 weeks was associated with lower birthweight of the larger twin (\u03b2: \u20130.09; p\u2009=\u20090.04). Inadequate weight gain from 24 weeks to delivery was associated with spontaneous preterm birth &lt;37 weeks' gestation (aOR: 1.67; 95% CI: 1.13\u20132.47), &lt;34 weeks' gestation (aOR: 4.32; 95% CI: 2.45\u20137.63), &lt;32 weeks' gestation (aOR: 9.07; 95% CI: 3.66\u201322.48), and a lower incidence of preeclampsia (aOR: 0.31; 95% CI: 0.16\u20130.63).<\/jats:p><jats:p>\n          Conclusion\u2003In twin pregnancies, gestational weight gain between 0 and 16 weeks as well as between 16 and 24 weeks is most associated with fetal growth, whereas gestational weight gain after 24 weeks is most associated with preterm birth. This may help elucidate the mechanism of action of the impact of gestational weight gain in twin pregnancies.<\/jats:p>","DOI":"10.1055\/s-0039-1700853","type":"journal-article","created":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T23:51:11Z","timestamp":1579564271000},"page":"567-574","source":"Crossref","is-referenced-by-count":11,"title":["The Association between Gestational Weight Gain in Each Trimester and Pregnancy Outcomes in Twin Pregnancies"],"prefix":"10.1055","volume":"38","author":[{"given":"Lilly Y.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York"},{"name":"Maternal Fetal Medicine Associates, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly B.","family":"Zafman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York"},{"name":"Maternal Fetal Medicine Associates, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan S.","family":"Fox","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York"},{"name":"Maternal Fetal Medicine Associates, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,1,20]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1016\/S0002-9378(97)70014-0","article-title":"Critical periods of maternal weight gain: effect on twin birth weight","volume":"177","author":"B Luke","year":"1997","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/0029-7844(95)00485-8","article-title":"Maternal weight gain patterns and birth weight outcome in twin gestation","volume":"87","author":"M E Lantz","year":"1996","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/0002-9378(93)90628-V","article-title":"The ideal twin pregnancy: patterns of weight gain, discordancy, and length of gestation","volume":"169","author":"B Luke","year":"1993","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1097\/AOG.0b013e3181e24afc","article-title":"Weight gain in twin pregnancies and adverse outcomes: examining the 2009 Institute of Medicine guidelines","volume":"116","author":"N S Fox","year":"2010","journal-title":"Obstet Gynecol"},{"issue":"16","key":"ref5","doi-asserted-by":"crossref","first-page":"1652","DOI":"10.3109\/14767058.2014.898058","article-title":"The association between maternal weight gain and spontaneous preterm birth in twin pregnancies","volume":"27","author":"N S Fox","year":"2014","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1515\/JPM.2005.088","article-title":"The evidence linking maternal nutrition and prematurity","volume":"33","author":"B Luke","year":"2005","journal-title":"J Perinat Med"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"346.e1","DOI":"10.1016\/j.ajog.2017.05.013","article-title":"Patterns of gestational weight gain and birthweight outcomes in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singletons: a prospective study","volume":"217","author":"S J Pugh","year":"2017","journal-title":"Am J Obstet Gynecol"},{"issue":"07","key":"ref9","doi-asserted-by":"crossref","first-page":"e0159500","DOI":"10.1371\/journal.pone.0159500","article-title":"Trimester-specific gestational weight gain and infant size for gestational age","volume":"11","author":"S B Sridhar","year":"2016","journal-title":"PLoS One"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1001\/jamapediatrics.2017.4016","article-title":"Association of timing of weight gain in pregnancy with infant birth weight","volume":"172","author":"R Retnakaran","year":"2018","journal-title":"JAMA Pediatr"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.ejogrb.2018.12.014","article-title":"Correlation between second trimester weight gain and perinatal outcomes in dichorionic twin pregnancies: the LoTiS cohort study","volume":"233","author":"L Wen","year":"2019","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref12","volume-title":"Nutrition during Pregnancy: Part I: Weight Gain; Part II: Nutrient Supplements","year":"1990"},{"key":"ref13","volume-title":"Weight Gain during Pregnancy: Reexamining the Guidelines","year":"2009"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"390.e1","DOI":"10.1016\/j.ajog.2008.12.018","article-title":"Gestational weight gain among US women who deliver twins, 2001-2006","volume":"200","author":"S Y Chu","year":"2009","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref15","first-page":"217","article-title":"Body mass index--specific weight gains associated with optimal birth weights in twin pregnancies","volume":"48","author":"B Luke","year":"2003","journal-title":"J Reprod Med"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/1471-2431-3-6","article-title":"A nearly continuous measure of birth weight for gestational age using a United States national reference","volume":"3","author":"E Oken","year":"2003","journal-title":"BMC Pediatr"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1053\/j.semperi.2008.02.009","article-title":"Growth abnormalities and multiple gestations","volume":"32","author":"J Cleary-Goldman","year":"2008","journal-title":"Semin Perinatol"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.ajog.2004.03.040","article-title":"Twins and triplets: the effect of plurality and growth on neonatal outcome compared with singleton infants","volume":"191","author":"T J Garite","year":"2004","journal-title":"Am J Obstet Gynecol"},{"issue":"06","key":"ref19","first-page":"1006","article-title":"Outcome of twin pregnancies according to intrapair birth weight differences","volume":"94","author":"L M Hollier","year":"1999","journal-title":"Obstet Gynecol"},{"issue":"04","key":"ref20","doi-asserted-by":"crossref","first-page":"355","DOI":"10.3109\/14767058.2013.818654","article-title":"Obesity and adverse pregnancy outcomes in twin pregnancies","volume":"27","author":"N S Fox","year":"2014","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"18","key":"ref21","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.3109\/14767058.2014.892069","article-title":"Impact of pre-gravid body mass index and body mass index change on preeclampsia and gestational diabetes in singleton and twin pregnancies","volume":"27","author":"M Lucovnik","year":"2014","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"05","key":"ref22","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1097\/AOG.0b013e318232125d","article-title":"Excessive weight gain in term twin pregnancies: examining the 2009 Institute of Medicine definitions","volume":"118","author":"N S Fox","year":"2011","journal-title":"Obstet Gynecol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0039-1700853.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T22:33:29Z","timestamp":1619908409000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0039-1700853"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,20]]},"references-count":21,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2021,5,1]]},"published-print":{"date-parts":[[2021,5]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0039-1700853","relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,20]]}}}