Risk Factors for Maternal Body Mass Index and Gestational Weight Gain in Twin Pregnancies

Abstract

Objective This retrospective cohort study analyzes risk factors for abnormal pre-pregnancy body mass index and abnormal gestational weight gain in twin pregnancies.

Methods Data from 10 603/13 682 twin pregnancies were analyzed using uni- and multivariable logistic regression models to determine risk factors for abnormal body mass index and weight gain in pregnancy.

Results Multiparity was associated with pre-existing obesity in twin pregnancies (aOR: 3.78, 95% CI: 2.71 – 5.27). Working in academic or leadership positions (aOR: 0.57, 95% CI: 0.45 – 0.72) and advanced maternal age (aOR: 0.96, 95% CI: 0.95 – 0.98) were negatively associated with maternal obesity. Advanced maternal age was associated with a lower risk for maternal underweight (aOR: 0.95, 95% CI: 0.92 – 0.99). Unexpectedly, advanced maternal age (aOR: 0.98, 95% CI: 0.96 – 0.99) and multiparity (aOR: 0.6, 95% CI: 0.41 – 0.88) were also associated with lower risks for high gestational weight gain. Pre-existing maternal underweight (aOR: 1.55, 95% CI: 1.07 – 2.24), overweight (aOR: 1.61, 95% CI: 1.39 – 1.86), obesity (aOR: 3.09, 95% CI: 2.62 – 3.65) and multiparity (aOR: 1.64, 95% CI: 1.23 – 2.18) were all associated with low weight gain. Women working as employees (aOR: 0.85, 95% CI: 0.73 – 0.98) or in academic or leadership positions were less likely to have a low gestational weight gain (aOR: 0.77, 95% CI: 0.64 – 0.93).

Conclusion Risk factors for abnormal body mass index and gestational weight gain specified for twin pregnancies are relevant to identify pregnancies with increased risks for poor maternal or neonatal outcome and to improve their counselling. Only then, targeted interventional studies in twin pregnancies which are desperately needed can be performed.

Zusammenfassung

Ziel Diese retrospektive Kohortenstudie analysiert die Risikofaktoren für einen abnormalen Body-Mass-Index vor der Schwangerschaft und eine abnormale Gewichtszunahme während der Schwangerschaft bei Zwillingsschwangerschaften.

Methoden Daten aus 10 603/13 682 Zwillingsschwangerschaften wurden mithilfe von univariablen und multivariablen logistischen Regressionsmodellen analysiert, um die Risikofaktoren für einen abnormalen Body-Mass-Index und eine abnormale Gewichtszunahme in der Schwangerschaft zu bestimmen.

Ergebnisse Multiparität war mit vorbestehender Adipositas bei Zwillingsschwangerschaften assoziiert (aOR 3,78; 95%-KI 2,71 – 5,27). Eine akademische Anstellung bzw. eine Führungsposition (aOR 0,57; 95%-KI 0,45 – 0,72) sowie fortgeschrittenes mütterliches Alter (aOR: 0,96, 95%-KI 0,95 – 0,98) waren negativ mit mütterlichem Adipositas assoziiert. Fortgeschrittenes mütterliches Alter war mit einem niedrigeren Risiko für mütterliches Untergewicht assoziiert (aOR 0,95; 95%-KI 0,92 – 0,99). Unerwarteterweise waren fortgeschrittenes mütterliches Alter (aOR 0,98; 95%-KI 0,96 – 0,99) sowie Multiparität (aOR 0,6; 95%-KI 0,41 – 0,88) auch mit einem niedrigeren Risiko für eine starke Gewichtszunahme in der Schwangerschaft assoziiert. Vorbestehendes mütterliches Untergewicht (aOR 1,55; 95%-KI 1,07 – 2,24), Übergewicht (aOR 1,61; 95%-KI 1,39 – 1,86), Adipositas (aOR 3,09; 95%-KI 2,62 – 3,65) und Multiparität (aOR 1,64; 95%-KI 1,23 – 2,18) waren alle mit einer niedrigeren Gewichtszunahme assoziiert. Die Wahrscheinlichkeit, dass Frauen, die als Angestellte (aOR 0,85; 95%-KI 0,73 – 0,98) oder in akademischen Stellungen arbeiteten oder Führungspositionen innehaben, in der Schwangerschaft nur wenig an Gewicht zulegen, war geringer (aOR 0,77; 95%-KI 0,64 – 0,93).

Schlussfolgerung Das Wissen um die Risikofaktoren für einen abnormalen Body-Mass-Index und eine abnormale Gewichtszunahme in der Schwangerschaft bei Zwillingsschwangerschaften ist wichtig, damit Schwangerschaften mit einem erhöhten Risiko eines schlechten mütterlichen oder kindlichen Outcomes frühzeitig identifiziert werden können und die Beratung dieser schwangeren Frauen dementsprechend verbessert werden kann. Nur dann können dringend benötigte gezielte Interventionsstudien bei Zwillingsschwangerschaften durchgeführt werden.

Key words

gestational weight gain - twin pregnancy - obesity - overweight - underweight

Schlüsselwörter

Gewichtszunahme in der Schwangerschaft - Zwillingsschwangerschaft - Adipositas - Übergewicht - Untergewicht

Publication History

Received: 28 January 2022

Accepted after revision: 27 April 2022

Article published online:
10 August 2022

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