{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:44:28Z","timestamp":1760244268263,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T00:00:00Z","timestamp":1662076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kyungpook National University Research Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background andObjectives: This study aimed to determine the correlation between maternal weight gain in each trimester and fetal growth according to pre-pregnancy maternal body mass index in twin pregnancies. Materials and Methods: We conducted a retrospective review of the medical records of 500 twin pregnancies delivered at 28 weeks\u2019 gestation or greater at a single tertiary center between January 2011 and December 2020. We measured the height, pre-pregnant body weight, and maternal body weight of women with twin pregnancies and evaluated the relationship between the maternal weight gain at each trimester and fetal growth restriction according to pre-pregnancy body mass index. Results: The overweight pregnant women were older than the normal or underweight pregnant women, and the risk of gestational diabetes was higher. The underweight pregnant women were younger, and the incidence of preterm labor and short cervical length during pregnancy was higher in the younger group. In normal weight pregnant women, newborn babies\u2019 weight was heavier when their mothers gained weight, especially when they gained weight in the second trimester. Mothers\u2019 weight gain in the first trimester was not a significant factor to predict fetal growth. The most predictive single factor for the prediction of small neonates was weight gain during 24\u201328 and 15\u201318 weeks, and the cutoff value was 6.2 kg (area under the curve 0.592, p &lt; 0.001). Conclusions: In twin pregnancy, regardless of the pre-pregnant body mass index, maternal weight gain affected fetal growth. Furthermore, weight gain in the second trimester of pregnancy is considered a powerful indicator of fetal growth, especially in normal weight pregnancies.<\/jats:p>","DOI":"10.3390\/medicina58091209","type":"journal-article","created":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T22:33:01Z","timestamp":1662503581000},"page":"1209","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Correlation between Maternal Weight Gain in Each Trimester and Fetal Growth According to Pre-Pregnancy Maternal Body Mass Index in Twin Pregnancies"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9770-1580","authenticated-orcid":false,"given":"Mi Ju","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu 41944, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun Mi","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu 41944, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4399-7627","authenticated-orcid":false,"given":"Hyun-Hwa","family":"Cha","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu 41944, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Won Joon","family":"Seong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu 41944, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists (2014). ACOG Practice Bulletin No. 144: Multifetal gestations: Twin, triplet, and higher-order multifetal pregnancies. Obstet. Gynecol., 123, 1118\u20131132.","DOI":"10.1097\/01.AOG.0000446856.51061.3e"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2080","DOI":"10.1080\/14767058.2019.1657085","article-title":"Neonatal outcomes between discordant monochorionic and dichorionic twins","volume":"34","author":"Park","year":"2019","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.fertnstert.2006.11.008","article-title":"Contemporary risks of maternal morbidity and adverse outcomes with increasing maternal age and plurality","volume":"88","author":"Luke","year":"2007","journal-title":"Fertil. Steril."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"380","DOI":"10.3109\/14767058.2016.1174209","article-title":"Hypertension in dichorionic twin gestations: How is birthweight affected?","volume":"30","author":"Sparks","year":"2017","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_5","first-page":"1","article-title":"Births: Final data for 2017","volume":"67","author":"Martin","year":"2018","journal-title":"Natl. Vital Stat. Rep."},{"key":"ref_6","first-page":"1","article-title":"Fetal and perinatal mortality: United States, 2013","volume":"64","author":"MacDorman","year":"2015","journal-title":"Natl. Vital Stat. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists (2004). ACOG Practice Bulletin #56: Multiple gestation: Complicated twin, triplet, and high-order multifetal pregnancy. Obstet. Gynecol., 104, 869\u2013883.","DOI":"10.1097\/00006250-200410000-00046"},{"key":"ref_8","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":"Pugh","year":"2017","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Sridhar, S.B., Xu, F., and Hedderson, M.M. (2016). Trimester-specific gestational weight gain and infant size for gestational age. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0159500"},{"key":"ref_10","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":"Luke","year":"1997","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_11","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":"Lantz","year":"1996","journal-title":"Obstet. Gynecol."},{"key":"ref_12","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":"Luke","year":"1993","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_13","unstructured":"Rasmussen, K.M., and Yaktine, A.L. (2009). The National Academies Collection: Reports funded by National Institutes of Health. Weight Gain during Pregnancy: Reexamining the Guidelines, National Academies Press. Copyright \u00a9. National Academy of Sciences."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Oken, E., Kleinman, K.P., Rich-Edwards, J., and Gillman, M.W. (2003). A nearly continuous measure of birth weight for gestational age using a United States national reference. BMC Pediatr., 3.","DOI":"10.1186\/1471-2431-3-6"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1002\/uog.15821","article-title":"ISUOG practice guidelines: Role of ultrasound in twin pregnancy","volume":"47","author":"Khalil","year":"2016","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"924","DOI":"10.3109\/00016341003657884","article-title":"Maternal super-obesity (body mass index > or = 50) and adverse pregnancy outcomes","volume":"89","author":"Alanis","year":"2010","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1111\/j.1467-789X.2008.00541.x","article-title":"Prepregnancy BMI and the risk of gestational diabetes: A systematic review of the literature with meta-analysis","volume":"10","author":"Torloni","year":"2009","journal-title":"Obes. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1080\/14767058.2019.1648421","article-title":"Weight gain and pregnancy outcomes in overweight or obese women with twin gestations","volume":"34","author":"Liu","year":"2021","journal-title":"J. Matern. Fetal Neonatal. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.tjog.2021.07.014","article-title":"Maternal pre-pregnancy body mass index and the risk for gestational diabetes mellitus in women with twin pregnancy in South Korea","volume":"60","author":"Kim","year":"2021","journal-title":"Taiwan J. Obstet. Gynecol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1055\/s-0039-1700853","article-title":"The association between gestational weight gain in each trimester and pregnancy outcomes in twin pregnancies","volume":"38","author":"Liu","year":"2021","journal-title":"Am. J. Perinatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2877","DOI":"10.1080\/14767058.2018.1562544","article-title":"Weight gain and pregnancy outcomes in underweight women with twin gestations","volume":"33","author":"Liu","year":"2020","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_22","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":"Lucovnik","year":"2014","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_23","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":"Fox","year":"2011","journal-title":"Obstet. Gynecol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1055\/s-0032-1304824","article-title":"The association of gestational weight gain per institute of medicine guidelines and prepregnancy body mass index on outcomes of twin pregnancies","volume":"29","author":"Kathiresan","year":"2012","journal-title":"Am. J. Perinatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"552","DOI":"10.3109\/14767058.2013.836177","article-title":"Perinatal outcomes based on the institute of medicine guidelines for weight gain in twin pregnancies","volume":"27","author":"Shamshirsaz","year":"2014","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s10995-016-2134-6","article-title":"Assessing weight gain by the 2009 Institute of Medicine guidelines and perinatal outcomes in twin pregnancy","volume":"21","author":"Ozcan","year":"2017","journal-title":"Matern. Child Health J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1097\/AOG.0000000000003504","article-title":"Gestational weight gain and adverse birth outcomes in twin pregnancies","volume":"134","author":"Bodnar","year":"2019","journal-title":"Obstet. Gynecol."},{"key":"ref_28","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":"Wen","year":"2019","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/9\/1209\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:22:32Z","timestamp":1760142152000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/9\/1209"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,2]]},"references-count":28,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["medicina58091209"],"URL":"https:\/\/doi.org\/10.3390\/medicina58091209","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2022,9,2]]}}}