ArticleInternational journal of obesity (2005)2020
The relationship between maternal body mass index and pregnancy outcomes in twin compared with singleton pregnancies.
Article in International journal of obesity (2005), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Pooled it
- Predictors of Adverse Pregnancy Outcomes in Pregnant Women Living with Obesity: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- Attenuated Impact of Gestational Diabetes Mellitus (GDM) With Hypertensive Disorders of Pregnancy (HDP) on Adverse Pregnancy Outcomes in Twin Versus Singleton Gestations: A Single-Center Real-World Study.Journal of diabetes research · 2026Article
- The effect of maternal pre-pregnancy body mass index on hypertensive disorders of pregnancy (HDP): a systematic review and dose-response meta-analysis of cohort studies involving 50 million pregnancies.EClinicalMedicine · 2025Article
- Management of twin pregnancies: Remaining challenges and unanswered questions.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Review
- Independent risk factors for twin pregnancy adverse fetal outcomes before 28 gestational week by first trimester ultrasound screening.World journal of radiology · 2025Article
- Anthropometric Measurements and Laboratory Methods for Pregnancy: An Update Review to Evaluation of Body Composition.Current nutrition reports · 2025Review
- Impact of maternal body mass index and gestational weight gain on maternal and neonatal outcomes in twin pregnancies.Acta obstetricia et gynecologica Scandinavica · 2023Article
- Risk Factors for Maternal Body Mass Index and Gestational Weight Gain in Twin Pregnancies.Geburtshilfe und Frauenheilkunde · 2022Article
- Impact of Pre-Pregnancy Hemoglobin Level on the Association Between Pre-Pregnancy Body Mass Index and Gestational Diabetes Mellitus: A Retrospective Cohort Study in a Single Center in China.Diabetes, metabolic syndrome and obesity : targets and therapy · 2022Article
- Association of parental prepregnancy BMI with neonatal outcomes and birth defect in fresh embryo transfer cycles: a retrospective cohort study.BMC pregnancy and childbirth · 2021Article
- Association between pregravid liver enzyme levels and gestational diabetes in twin pregnancies: a secondary analysis of national cohort study.Scientific reports · 2021Article
- Association of maternal pre-pregnancy low or increased body mass index with adverse pregnancy outcomes.Scientific reports · 2021Article
- Association Between Pre-Pregnancy Body Mass Index and Miscarriage in an Assisted Reproductive Technology Population: A 10-Year Cohort Study.Frontiers in endocrinology · 2021Article
- Perinatal Outcomes and Risk Factors for Preterm Birth in Twin Pregnancies in a Chinese Population: A Multi-center Retrospective Study.Frontiers in medicine · 2021Article
Corrections and comments
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Authors and funding
11 authors at 8 institutions in 2 countries.
Funding
Abstract
objeciveWomen with twins have an a priori increased risk for many of the complications associated with maternal obesity. Thus, the impact of maternal obesity in twins may differ from that reported in singletons. In addition, given the increased metabolic demands in twin pregnancies, the impact of maternal underweight may be greater in twin compared with singleton gestations. Our objective was to test the hypothesis that the relationship between maternal pre-pregnancy body mass index (BMI) and adverse pregnancy outcomes differ between twin and singleton gestations.
methodsThis was a retrospective population-based study of all women who had a singleton or twin hospital birth in Ontario, Canada, between April 2012 and March 2016. Data were obtained from the Better Outcomes Registry & Network (BORN) Ontario. The relationship between maternal BMI category and pregnancy complications was assessed separately in twin and singleton gestations. The primary outcome was a composite variable that included any of the following complications: preeclampsia, gestational diabetes, or preterm birth before 32
resultsA total of 487,870 women with singleton (n = 480,010) and twin (n = 7860) pregnancies met the inclusion criteria. The risk of the composite primary outcome, preeclampsia, gestational diabetes, and cesarean delivery increased with high maternal BMI in both singleton and twin gestations, but these associations were weaker in twin compared with singleton gestations (association of BMI ≥ 40.0 kg/m
conclusionIn healthy women with twin pregnancies, underweight is associated with the greatest risk for preterm birth, while the association of maternal obesity with adverse pregnancy outcomes is weaker than that observed in singletons.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.