The ideal twin pregnancy: Patterns of weight gain, discordancy, and length of gestation

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Objective: Our purpose was to evaluate factors associated with the best intrauterine growth and lowest morbidity among twins (“ideal twin pregnancy”).

Study Design: A historic prospective study of 163 twin births was performed. Ten models were formulated with multiple regression and multivariate logistic regression.

Results: In the models of birth weight, gestations of 28 to 36 and 39 to 41 weeks, black race, ≥ 15% discordancy, and smoking were all significant negative factors. The pattern of early low weight gain (<0.85 pounds per week before 24 weeks) and late low weight gain (< 1.0 pound per week after 24 weeks) was negatively associated with all eight models of intrauterine growth.

Conclusions: The best intrauterine growth and lowest morbidity is achieved earlier for twins than for singletons. Using length of stay and growth retardation critera, nearly 70% of “ideal” twin pregnancies were between 35 and 38 weeks. In addition, poor weight gain and poor patterns of weight gain were associated with all measures of intrauterine growth and adverse pregnancy outcomes.

Key words

Twins
length of gestation
weight gain

Cited by (0)

Supported by March of Dimes Birth Defects Foundation grant no. 5-565, and by the Center for the Study of Multiple Birth.

a

From the Section of Reproductive and Perinatal Epidemiology, Department of Obstetrics and Gynecology, Rush Medical College, Rush-Presbyterian-St. Luke's Medical Center

b

Center for the Study of Multiple Birth

c

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Johns Hopkins University School of Medicine

d

Office of the President, DePaul University

e

Department of Obstetrics and Gynecology, Northwestern University Medical School and Prentice Women's Hospital and Maternity Center

f

Department of Obstetrics and Gynecology, University of Michigan Medical School