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Ashtree DN, Osborne DA, Lee A, Umstad MP, Craig JM, Scurrah KJ. Three trajectories of gestational weight gain identified in an Australian twin study. Eur J Obstet Gynecol Reprod Biol 2022; 275:24-30. [PMID: 35714501 DOI: 10.1016/j.ejogrb.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/19/2022] [Accepted: 06/07/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Gestational weight gain (GWG) has been associated with maternal and child health outcomes, but knowledge of appropriate GWG for twin gestations is limited. STUDY DESIGN The Peri/Postnatal Epigenetic Twins Study is a prospective twin cohort study of 250 women and their twin children in Melbourne, Australia. We modeled trajectories of GWG using group-based growth modeling and compared these trajectories to GWG categories (within, above, or below current GWG recommendations for twin pregnancy). We fitted robust linear and Poisson regression models to assess associations of maternal pre-pregnancy and gestational exposures with risk of gaining weight outside the recommendations. RESULTS Of the 250 women enrolled in the PETS, GWG measures were available for 172 women. Forty-seven percent of women had GWG within the current recommendations. We identified three GWG trajectories - 23.6% of women had low GWG throughout pregnancy, 34.5% had average GWG throughout pregnancy, and 42.0% had average initial GWG, followed by high GWG from trimester two until delivery. Gestational diabetes mellitus (GDM) was associated with increased risk of inadequate GWG (RR: 2.40, 95%CI: 1.53, 3.75). Pre-pregnancy obesity (RR: 1.88, 95%CI: 1.09, 3.26) and hypertensive disorders of pregnancy (RR: 2.64, 95%CI: 1.20, 5.81) were associated with increased risk of excessive GWG. CONCLUSIONS More than half of the women in the PETS did not meet the current GWG recommendations. Women with GDM or hypertensive disorders were more likely to gain weight outside these guidelines. More research is needed to establish comprehensive guidelines for twin pregnancies.
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Affiliation(s)
- Deborah N Ashtree
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Parkville, Australia; Twins Research Australia, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Parkville, Australia.
| | - Deborah A Osborne
- Twins Research Australia, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Amelia Lee
- Nutrition Department, Royal Women's Hospital, Parkville, Australia; School of Exercise and Nutrition Science, Faculty of Health, Deakin University, Burwood, Australia
| | - Mark P Umstad
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia; Department of Maternal Fetal Medicine, Royal Women's Hospital, Parkville, Australia
| | - Jeffrey M Craig
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Australia; Epigenetics, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia
| | - Katrina J Scurrah
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Parkville, Australia; Twins Research Australia, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Parkville, Australia; Centre for Mental Health, School of Population and Global Health, University of Melbourne, Parkville, Australia
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