Abstract:
Objectives: To examine the influence of maternal pre-pregnancy
body weight on fetomaternal outcomes in twin pregnancies.
Study design: Retrospective study.
Setting: Department of Obstetrics and Gynecology, Buergerhospital
Frankfurt am Main, Hessen, Germany
Population: 2,449 women delivering twins between 2005 and 2020 at
the Buergerhospital Frankfurt, Gemany.
Methods: The mothers were categorized according to their
pre-gravid body mass index into underweight, normal weight, overweight,
obese, and obesity classes I – III.
Main outcome measures: Gestational diabetes mellitus (GDM),
preeclampsia/HELLP syndrome, intrauterine death (IUD), cesarean section
or vaginal delivery, wound healing disorders, postpartum hemorrhage
(PPH), uterine atony, preterm birth, birth weight discordance, admission
to the neonatal intensive care unit (NICU), pH of the umbilical artery,
and a 5’-APGAR score <7.
Results: Obese mothers had a significantly higher risk for GDM
(OR = 0.36; 95% CI 0.19 – 0.7 compared to underweight; OR = 0.32; 95%
CI 0.23 – 0.43 compared to normal weight; OR = 0.47; 95% CI 0.33 –
0.69 compared to overweight), and wound healing disorders (OR = 0.19;
95% CI 0.09 – 0.4 compared to normal weight). Neonates of obese
mothers showed significant results for umbilical artery pH of 7.01 –
7.1 (OR = 0.45; 95% CI 0.24 – 0.86 compared to overweight). Neonates
of obesity class III mothers had a significantly higher risk for NICU
admission (OR = 0.38; 95% CI 0.17 – 0.83 compared to obesity class I).
No significant results were observed for the remaining main outcome
measures.
Conclusions: Obesity, and overweight represent risk factors for
adverse fetomaternal outcomes in twin pregnancies.
Keywords: twin pregnancies; maternal obesity; pre-pregnancy
weight; fetomaternal outcome; gestational diabetes mellitus; neonatal
intensive care unit; umbilical artery pH; wound healing
disorders