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Dai J, Fan X, He J, Tian R, Xu J, Song J, Chen X, Han L, Chen Y, Peng L, Cao Q, Bai J, Chen Z, Liu Y, Zou Z, Chen X. Is the Gestational Weight Gain Recommended by the National Academy of Medicine Guidelines Suitable for Chinese Twin-Pregnant Women with Gestational Diabetes Mellitus? Am J Perinatol 2024; 41:e331-e340. [PMID: 36113492 DOI: 10.1055/s-0042-1754319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES This study aimed to assess the applicability of the National Academy of Medicine (NAM) interim guidelines for twin pregnancies to the specific population of gestational diabetes mellitus by exploring the relationship between gestational weight gain and adverse pregnancy outcomes in Chinese twin-pregnant women with gestational diabetes mellitus. STUDY DESIGN This was a retrospective cohort study of women diagnosed with diabetes in pregnancy between July 2017 and December 2020 at the Maternal and Child Health Hospital in Chongqing, China. The primary variable of interest was maternal total gestational weight gain. The primary outcomes were perinatal outcomes, which included: preeclampsia, small for gestational age, large for gestational age, low birth weight, neonatal pneumonia, neonatal respiratory distress syndrome, and neonatal intensive unit admission, etc. The association between inappropriate gestational weight gain and adverse pregnancy outcomes was estimated using multiple logistic regression analysis. RESULTS A total of 455 twin-pregnant women who had gestational diabetes mellitus were analyzed. Women with low gestational weight gain had reduced risk of preeclampsia (adjusted odds ratio [aOR], 0.32; 95% CI or confidence interval, 0.17-0.63; p = 0.001) and their infants had higher risks of small for gestational age (aOR, 1.93; 95% CI, 1.04-3.58; p = 0.037), low birth weight (aOR, 2.27; 95% CI, 1.32-3.90; p = 0.003), neonatal intensive unit admission (aOR, 3.29; 95% CI, 1.10-5.78; p = 0.038), pneumonia (aOR, 2.41; 95% CI, 1.08-5.33; p = 0.031), and neonatal respiratory distress syndrome (aOR, 2.29; 95% CI, 1.10-4.78; p = 0.027); the infants of women with excessive gestational weight gain had a higher risk of large for gestational age (aOR, 3.76; 95% CI, 1.42-9.96; p = 0.008). CONCLUSION Gestational weight gain controlled within the range recommended by the NAM could reduce the risk of perinatal adverse outcomes. The 2009 NAM gestational weight gain recommendations can be used for Chinese twin-pregnant women with gestational diabetes mellitus. KEY POINTS · Inappropriate gestational weight gain can lead to adverse perinatal outcomes in twin pregnancies.. · Gestational weight gain controlled within recommended range could reduce the risk of poor perinatal outcomes.. · The National Academy of Medicine recommendations are suitable for Chinese twin-pregnant women with GDM..
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Affiliation(s)
- Jiamiao Dai
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Xiaoxiao Fan
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Jing He
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Ruixue Tian
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Jingqi Xu
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Jiayang Song
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Xiangxu Chen
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Lu Han
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Yanlin Chen
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Li Peng
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Qiongya Cao
- School of Nursing, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Zhen Chen
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China
| | - Yanqun Liu
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Zhijie Zou
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Xiaoli Chen
- Maternal and Child Health and Metabolism Research Center, School of Nursing, Wuhan University, Wuhan, Hubei, China
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Le J, Lv ZH, Peng R, Li Y, Wang ST. Evaluation of Vitamin D Status and the Analysis of Risk Factors of Vitamin D Deficiency in Twin Pregnancies. Lab Med 2023; 54:534-542. [PMID: 36869835 DOI: 10.1093/labmed/lmad005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
OBJECTIVE Optimization of maternal vitamin D (VD) status has beneficial effects on pregnancies, but little is known about it of twin pregnancies (TP). Our aim was to promote the current understanding of VD status and its associated factors in TP. METHODS We performed liquid chromatography-tandem mass spectrometry to quantify 25-hydroxyvitamin D [25(OH)D] and used the enzyme-linked immunosorbent assay method to detect vitamin D binding protein (VDBP) in 218 singleton pregnancies (SP) and 236 TP. RESULTS Levels of 25(OH)D and VDBP were higher in TP than SP. The 25(OH)D, free 25(OH)D, C-3 epimer of 25-hydroxyvitamin D [epi-25(OH)D], and VDBP all increased with gestational progress. Age, body
mass index, and hemoglobin level were associated with VD deficiency (VDD). Analysis of covariance demonstrated that the 25(OH)D and VDBP of TP and SP still showed differences after adjusting for the above associated factors. CONCLUSION Differences in VD status were found in SP and TP, suggesting that the assessment of VD status in TP should be treated with caution. High VDD prevalence is observed among pregnant Chinese women, and it is recommended to promote evaluation for VDD.
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Affiliation(s)
- Juan Le
- Department of Clinical Laboratory, Wuhan University, Renmin Hospital, Wuhan, China
| | - Zhi-Hua Lv
- Department of Clinical Laboratory, Wuhan University, Renmin Hospital, Wuhan, China
| | - Rui Peng
- Department of Clinical Laboratory, Wuhan University, Renmin Hospital, Wuhan, China
| | - Yan Li
- Department of Clinical Laboratory, Wuhan University, Renmin Hospital, Wuhan, China
| | - Shao-Ting Wang
- Department of Clinical Laboratory, Wuhan University, Renmin Hospital, Wuhan, China
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Anderson JN, Deter RL, Datoc IA, Mack L, Gandhi M, Lee W, Blumenfeld YJ. Second-trimester growth velocities in twin and singleton pregnancies. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 61:33-39. [PMID: 36273412 DOI: 10.1002/uog.26102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/04/2022] [Accepted: 10/14/2022] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Previous small studies used individualized growth assessment (IGA) to characterize prenatal growth velocities of singletons and twins. We aimed to compare second-trimester growth velocities of individual anatomical parameters between monochorionic diamniotic (MCDA) twins, dichorionic diamniotic (DCDA) twins and singleton fetuses in a larger study. METHODS This was a study of a novel cohort of 222 MCDA twins and previously published cohorts of 40 DCDA twins and 118 singletons with serial ultrasound data. Fetal biometric measurements of biparietal diameter, head circumference, abdominal circumference and femur diaphysis length from prenatal ultrasound examinations were used to calculate second-trimester growth velocities using direct calculation or linear regression analysis. Linear fit was assessed based on the coefficient of determination (R2 ). Mean growth velocities and variances were compared among the three groups. RESULTS The majority of cases underwent three second-trimester ultrasound examinations with fetal biometry available. All fetuses had linear growth, with R2 > 99% for all parameters. Only 1-2% of all MCDA and DCDA anatomical parameters had abnormal growth velocity scores outside the 95% reference range for singletons. There were no significant differences in mean growth velocity for any parameter between MCDA twins and singletons. Femur diaphysis length growth velocity was significantly lower in DCDA twins than in both MCDA twins and singletons. There were no other significant differences among the groups. CONCLUSIONS Expanding on prior work using IGA, we found that second-trimester growth velocity of the four major anatomical parameters overall was similar between twins and singletons and between MCDA and DCDA twins, supporting the use of singleton-derived growth standards for IGA in twins. Twin growth potential appears to be similar to that of singletons in the second trimester, suggesting that subsequent growth divergence may be due to third-trimester physiological or pathological changes in twin pregnancies. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- J N Anderson
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Stanford, CA, USA
| | - R L Deter
- Baylor College of Medicine/Texas Children's Pavilion for Women, Department of Obstetrics and Gynecology, Houston, TX, USA
| | - I A Datoc
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Stanford, CA, USA
| | - L Mack
- Baylor College of Medicine/Texas Children's Pavilion for Women, Department of Obstetrics and Gynecology, Houston, TX, USA
| | - M Gandhi
- Baylor College of Medicine/Texas Children's Pavilion for Women, Department of Obstetrics and Gynecology, Houston, TX, USA
| | - W Lee
- Baylor College of Medicine/Texas Children's Pavilion for Women, Department of Obstetrics and Gynecology, Houston, TX, USA
| | - Y J Blumenfeld
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Stanford, CA, USA
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Dimitris MC, Kaufman JS, Bodnar LM, Platt RW, Himes KP, Hutcheon JA. Gestational Diabetes in Twin Versus Singleton Pregnancies With Normal Weight or Overweight Pre-Pregnancy Body Mass Index: The Mediating Role of Mid-Pregnancy Weight Gain. Epidemiology 2022; 33:278-286. [PMID: 34907972 PMCID: PMC8810679 DOI: 10.1097/ede.0000000000001454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Gestational diabetes might be more common in twin versus singleton pregnancies, yet the reasons for this are unclear. We evaluated the extent to which this relationship is explained by higher mid-pregnancy weight gain within normal weight and overweight pre-pregnancy body mass index (BMI) strata. METHODS We analyzed serial weights and glucose screening and diagnostic data abstracted from medical charts for twin (n = 1397) and singleton (n = 3117) pregnancies with normal or overweight pre-pregnancy BMI delivered from 1998 to 2013 at Magee-Womens Hospital in Pennsylvania. We used causal mediation analyses to estimate the total effect of twin versus singleton pregnancy on gestational diabetes, as well as those mediated (natural indirect effect) and not mediated (natural and controlled direct effects) by pathways involving mid-pregnancy weight gain. RESULTS Odds of gestational diabetes were higher among twin pregnancies [odds ratios (ORs) for total effect = 2.83 (95% CI = 1.54, 5.19) for normal weight and 2.09 (95% CI = 1.16, 3.75) for overweight pre pregnancy BMI], yet there was limited evidence that this relationship was mediated by mid-pregnancy weight gain [ORs for natural indirect effect = 1.21 (95% CI = 0.90, 1.24) for normal weight and 1.06 (95% CI = 0.92, 1.21) for overweight pre-pregnancy BMI] and more evidence of mediation via other pathways [ORs for natural direct effect = 2.34 (95% CI = 1.24, 4.40) for normal weight and 1.97 (95% CI = 1.08, 3.60) for overweight pre-pregnancy BMI]. CONCLUSIONS While twin pregnancies with normal weight or overweight pre-pregnancy BMI experienced higher odds of gestational diabetes versus singletons, most of this effect was explained by pathways not involving mid-pregnancy weight gain.
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Affiliation(s)
- Michelle C Dimitris
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University
| | - Lisa M Bodnar
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, University of Pittsburgh
| | - Robert W Platt
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University
| | - Katherine P Himes
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, University of Pittsburgh
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Lee W. Soft tissue assessment for fetal growth restriction. Minerva Obstet Gynecol 2021; 73:442-452. [PMID: 33978351 DOI: 10.23736/s2724-606x.21.04829-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Contemporary clinical practice heavily relies on interpretation of population-based birth weight standards to evaluate neonatal nutrition status. Obstetricians have adopted the use of estimated fetal weight in a similar manner to estimate fetal nutritional status. However, most fetal weight prediction models overemphasize skeletal parameters such as biparietal diameter, head circumference, and femur diaphysis length. Although most EFW calculations also include abdominal circumference, this 2D growth parameter is largely defined by liver size and a small rim of subcutaneous fat. Advances in 3D ultrasound imaging and the development of more robust image analysis tools have now made it possible to reliably add a soft tissue component for fetal nutritional assessment. This chapter explains why fetal soft tissue evaluation is clinically relevant, describes different techniques for evaluating these sonographic parameters, and outlines future directions for their practical utility in the care of malnourished fetuses.
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Affiliation(s)
- Wesley Lee
- Division of Women's and Fetal Imaging, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA -
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Abstract
PURPOSE OF THE REVIEW The purpose of this review was to compare physiological and metabolic changes in singleton and twin gestations and to review pregnancy outcomes with respect to current weight gain guidelines. RECENT FINDINGS Reviews in singleton gestations show that weight gain below the recommended guidelines has been associated with small for gestational age infants (less than the 10th percentile) which place these infants at increased risk for neonatal morbidities. Observational studies have shown that adequate and excessive gestational weight gain in twin gestations has been associated with longer gestations and less preterm birth along with increased birth weight at delivery. Weight gain in pregnancy has been identified as a factor that affects both maternal and infant health outcomes in singleton and twin gestations. There is a larger body of research examining these effects in singleton gestations than twin gestations; however, in both groups, the data remain mostly observational and retrospective. Thus far, the research supports the Institute of Medicine recommended weight gain guidelines in singleton and twin gestations for women with normal BMI, but future research should be directed toward underweight and overweight women and the long-term outcomes in all mothers and their offspring.
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Affiliation(s)
- Manisha Gandhi
- Baylor College of Medicine, 6651 Main St, Suite 1096, Houston, TX, 77030, USA.
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Whitaker KM, Ryan R, Becker C, Healy H. Gestational Weight Gain in Twin Pregnancies and Maternal and Child Health: An Updated Systematic Review. J Womens Health (Larchmt) 2021; 31:362-381. [PMID: 33926213 DOI: 10.1089/jwh.2021.0009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: The Institute of Medicine (IOM) has provisional gestational weight gain (GWG) guidelines for women pregnant with twins due to limited data in this population. To better inform guidelines, the objective of this systematic review was to build on prior work and examine recent data on the associations of GWG with maternal and child health in twin pregnancies. Materials and Methods: In February 2021, Ovid MEDLINE, Embase, CINAHL, and Cochrane Library were searched. Observational studies were eligible if published from January 1, 2013 through February 23, 2021, and examined associations of GWG with maternal or child health outcomes after accounting for gestational age at delivery and pre-pregnancy body mass index. Heterogeneity across studies precluded the use of meta-analytic methods. Results: A total of 29 studies were included. For maternal outcomes, excessive GWG was associated with an increased risk of hypertensive disorders of pregnancy; whereas studies examining gestational diabetes and delivery method reported mixed findings. For child outcomes, inadequate GWG was associated with lower birthweight, small for gestational age, and preterm birth. Adequate or excessive GWG was associated with later gestational age at delivery. Conclusions: This study advances an earlier review by including a more diverse array of maternal and child outcomes. Many of the limitations noted in the original review persist; for example, no studies examined the associations of GWG and outcomes beyond birth. Although it appears that GWG within the IOM guidelines is associated with more optimal outcomes, additional methodologically rigorous studies are needed to better inform evidence-based guidelines.
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Affiliation(s)
- Kara M Whitaker
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa, USA.,Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Rachel Ryan
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa, USA
| | - Courtney Becker
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa, USA
| | - Heather Healy
- Hardin Library for the Health Sciences, University of Iowa Libraries, Iowa City, Iowa, USA
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Whitaker KM, Baruth M, Schlaff RA, Connolly CP, Liu J, Wilcox S. Association of provider advice and gestational weight gain in twin pregnancies: a cross-sectional electronic survey. BMC Pregnancy Childbirth 2020; 20:417. [PMID: 32703169 PMCID: PMC7376962 DOI: 10.1186/s12884-020-03107-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 07/10/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Little is known about patient-provider communication on gestational weight gain among women pregnant with twins, a growing population at high risk for adverse maternal and neonatal outcomes. We examined if women's report of provider advice on gestational weight gain was consistent with the Institute of Medicine (IOM) weight gain guidelines for twin pregnancies, and the association of provider advice on weight gain with women's weight gain during their twin pregnancy. METHODS We conducted a cross-sectional survey of 276 women who delivered twins and received prenatal care in the United States. The 2009 IOM provisional weight gain guidelines for twin pregnancies defined whether provider advice on weight gain and women's weight gain were below, within, or above guidelines. Multinomial logistic regression examined associations between provider advice on weight gain with women's weight gain, after adjustment for maternal age, gestational age at delivery, education, parity, twin type, use of assisted reproductive technologies and pre-pregnancy BMI category. RESULTS Approximately 30% of women described provider advice on weight gain below the IOM guidelines, 60% within, and 10% above guidelines. Compared to women who reported weight gain advice within guidelines, women who reported advice below guidelines or who reported no advice were 7.1 (95% CI: 3.2, 16.0) and 2.7 (95% CI: 1.3, 5.6) times more likely to gain less than recommended, respectively. Women who reported provider advice above guidelines were 4.6 (95% CI: 1.5, 14.2) times more likely to exceed guidelines. CONCLUSIONS Provider advice on gestational weight gain may be an important predictor of women's weight gain during twin pregnancies, highlighting the critical need for accurate provider counseling to optimize health outcomes.
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Affiliation(s)
- Kara M Whitaker
- Department of Health and Human Physiology and Department of Epidemiology, University of Iowa, E116 Field House, Iowa City, IA, 52242, USA.
| | - Meghan Baruth
- Department of Health Sciences, Saginaw Valley State University, University Center, MI, USA
| | - Rebecca A Schlaff
- Department of Health Sciences, Saginaw Valley State University, University Center, MI, USA
| | - Christopher P Connolly
- Department of Educational Leadership, Sports Studies, and Educational/Counseling Psychology, Washington State University, Pullman, Washington, USA
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Sara Wilcox
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
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Gandhi M, Gandhi R, Mack LM, Shypailo R, Adolph AL, Puyau MR, Wong WW, Deter RL, Sangi-Haghpeykar H, Lee W, Butte NF. Estimated energy requirements increase across pregnancy in healthy women with dichorionic twins. Am J Clin Nutr 2018; 108:775-783. [PMID: 30321279 DOI: 10.1093/ajcn/nqy184] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 07/12/2018] [Indexed: 12/31/2022] Open
Abstract
Background Estimated energy requirement (EER) has not been defined for twin pregnancy. This study was designed to determine the EER of healthy women with dichorionic-diamniotic (DCDA) twin pregnancies. Objectives We aimed to estimate energy deposition from changes in maternal body protein and fat; to measure resting energy expenditure (REE), physical activity level (PAL), and total energy expenditure (TEE) throughout pregnancy and postpartum; and to define the EER based on the sum of TEE and energy deposition for twin gestation. Design This is a prospective study of 20 women with DCDA twin gestations. Maternal EER, energy deposition, REE, TEE, and PAL were obtained during the first, second, and third trimesters of pregnancy and immediately postpartum. A mixed-effects linear regression model for repeated measures with random intercept was used to test for the effects of BMI groups and time. Results Gains in total body protein (mean ± SD: 2.1 ± 0.7 kg) and fat mass (5.9 ± 2.8 kg) resulted in total energy deposition of 67,042 ± 25,586 kcal between 0 and 30-32 weeks of gestation. REE increased 26% from 1392 ± 162 to 1752 ± 172 kcal/d across the 3 trimesters, whereas TEE increased 17% from 2141 ± 283 to 2515 ± 337 kcal/d. Physical activity decreased steadily throughout pregnancy. Reductions in physical activity did not compensate for the rise in REE and energy deposition, thus requiring an increase in dietary energy intake as pregnancy progressed. EER increased 29% from 2257 ± 325 kcal/d in the first trimester to 2941 ± 407 kcal/d in the second trimester, and stayed consistent at 2906 ± 350 kcal/d in the third trimester. Conclusion Increased energy intake, on average ∼700 kcal/d in the second and third trimesters when compared with the first trimester, is required to support gestational weight gain and the rise in energy expenditure of DCDA twin pregnancies.
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Affiliation(s)
- Manisha Gandhi
- Department of Obstetrics & Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, TX
| | - Rajshi Gandhi
- Department of Obstetrics & Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, TX
| | - Lauren M Mack
- Department of Obstetrics & Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, TX
| | - Roman Shypailo
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Anne L Adolph
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Maurice R Puyau
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - William W Wong
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Russell L Deter
- Department of Obstetrics & Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, TX
| | - Haleh Sangi-Haghpeykar
- Department of Obstetrics & Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, TX
| | - Wesley Lee
- Department of Obstetrics & Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, TX
| | - Nancy F Butte
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
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