ArticleObstetrics and gynecology2019
Gestational Weight Gain and Adverse Birth Outcomes in Twin Pregnancies.
Article in Obstetrics and gynecology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis 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
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Gestational Weight Gain and Its Effects on Maternal and Neonatal Outcome in Women With Twin Pregnancies: A Systematic Review and Meta-Analysis.Frontiers in pediatrics · 2021Pooled it
- Gestational weight gain and perinatal outcomes in twin pregnancies: evidence-based insights from a Chinese population cohort.Annals of medicine · 2026Observational
- Phthalate Metabolites in Maternal Urine and Breast Milk After Very Preterm Birth: Matrix Concordance.Toxics · 2026Article
- Association of gestational weight gain with adverse pregnancy outcomes across body mass index categories for twins in China.Frontiers in reproductive health · 2026Article
- Association of gestational weight gain with pregnancy complications and delivery outcomes in twins: a study in Northern China.BMC pregnancy and childbirth · 2025Article
- Association between gestational weight change trajectories and perinatal outcomes in twin pregnancies in China.BMC pregnancy and childbirth · 2025Article
- Impact of Pre-Pregnancy Body Mass Index and Gestational Weight Gain on Pregnancy Complications and Outcomes.International journal of general medicine · 2025Article
- Association between obesity in women with multiple gestations and adverse obstetric outcomes: a study of an American population database with over 136,000 unique deliveries.Archives of gynecology and obstetrics · 2025Article
- Association between inadequate weight gain according to the institute of medicine 2009 guidelines and pregnancy outcomes in women with thyroid disorders.Archives of gynecology and obstetrics · 2024Article
- Prenatal Weight Change Trajectories and Perinatal Outcomes among Twin Gestations.American journal of perinatology · 2024Article
- Investigating the Shape and Strength of the Relationship Between Maternal Weight Gain and Gestational Age at Delivery in Twin and Singleton Pregnancies.American journal of epidemiology · 2023Article
- Effect of alcohol consumption on breast cancer: probabilistic bias analysis for adjustment of exposure misclassification bias and confounders.BMC medical research methodology · 2023Article
- Weight gain patterns among pregnancies with obesity and small- and large-for-gestational-age births.Obesity (Silver Spring, Md.) · 2023Article
- Impact of maternal body mass index and gestational weight gain on maternal and neonatal outcomes in twin pregnancies.Acta obstetricia et gynecologica Scandinavica · 2023Article
- Lifestyle Interventions to Improve Pregnancy Outcomes: a Systematic Review and Specified Meta-Analyses.Geburtshilfe und Frauenheilkunde · 2022Article
- Correlation between Maternal Weight Gain in Each Trimester and Fetal Growth According to Pre-Pregnancy Maternal Body Mass Index in Twin Pregnancies.Medicina (Kaunas, Lithuania) · 2022Article
- Risk Factors for Maternal Body Mass Index and Gestational Weight Gain in Twin Pregnancies.Geburtshilfe und Frauenheilkunde · 2022Article
- Risk factors for twin pregnancy in women undergoing double cleavage embryo transfer.BMC pregnancy and childbirth · 2022Article
- Review of Dietary Recommendations for Twin Pregnancy: Does Nutrition Science Keep Up with the Growing Incidence of Multiple Gestations?Nutrients · 2022Review
- Clinical analysis on the influencing factors related to preterm twin pregnancy.Revista da Associacao Medica Brasileira (1992) · 2022Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveTo evaluate the association between gestational weight gain in twin pregnancies and small-for-gestational-age (SGA) and large-for-gestational-age (LGA) birth, preterm birth before 32 weeks of gestation, cesarean delivery, and infant death within each prepregnancy body mass index (BMI) category.
methodsData in this population-based study came from Pennsylvania-linked infant birth and death records (2003-2013). We studied 54,836 twins born alive before 39 weeks of gestation. Total pregnancy weight gain (kg) was converted to gestational age-standardized z scores. Multivariable modified Poisson regression models stratified by prepregnancy BMI were used to estimate associations between z scores and outcomes. A probabilistic bias analysis, informed by an internal validation study, evaluated the effect of BMI and weight gain misclassification.
resultsGestational weight gain z score was negatively associated with SGA and positively associated with LGA and cesarean delivery in all BMI groups. The relation between weight gain and preterm birth was U-shaped in nonobese women. An increased risk of infant death was observed for very low weight gain among normal-weight women and for high weight gain among women without obesity. Most excess risks of these outcomes were observed at weight gains at 37 weeks of gestation that are equivalent to less than 14 kg or more than 27 kg in underweight or normal-weight women, less than 11 kg or more than 28 kg in overweight women, and less than 6.4 kg or more than 26 kg in women with obesity. The bias analysis supported the validity of the conventional analysis.
conclusionVery low or very high weight gains were associated with the adverse outcomes we studied. If the associations we observed are even partially reflective of causality, targeted modification of pregnancy weight gain in women carrying twins might improve pregnancy outcomes.
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