Location: Children's Nutrition Research CenterTitle: Impact of changes in maternal body composition on birth weight and neonatal fat mass in dichorionic twin pregnancies
|GANDHI, MANISHA - Baylor College Of Medicine|
|GANDHI, RAJSHI - Baylor College Of Medicine|
|MACK, LAUREN - Baylor College Of Medicine|
|SHYPAILO, ROMAN - Children'S Nutrition Research Center (CNRC)|
|ADOLPH, ANNE - Children'S Nutrition Research Center (CNRC)|
|PUYAU, MAURICE - Children'S Nutrition Research Center (CNRC)|
|WONG, WILLIAM - Children'S Nutrition Research Center (CNRC)|
|DETER, RUSSELL - Baylor College Of Medicine|
|SANGI-HAGHPEYKAR, HALEH - Baylor College Of Medicine|
|LEE, WESLEY - Baylor College Of Medicine|
|BUTTE, NANCY - Children'S Nutrition Research Center (CNRC)|
Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/9/2018
Publication Date: 10/12/2018
Citation: Gandhi, M., Gandhi, R., Mack, L.M., Shypailo, R., Adolph, A.L., Puyau, M.R., Wong, W.W., Deter, R.L., Sangi-Haghpeykar, H., Lee, W., Butte, N.F. 2018. Impact of changes in maternal body composition on birth weight and neonatal fat mass in dichorionic twin pregnancies. American Journal of Clinical Nutrition. 108(4):716-721. https://doi.org/10.1093/ajcn/nqy180.
Interpretive Summary: Changes in maternal food intake during pregnancy have been shown to affect the weight and fat content of the newborn. The effect of maternal weight during twin pregnancy on the body weight and fat content of the newborn is not well known. This knowledge will provide important guidance on the optimal weight gain for mothers with twin pregnancy. We enrolled 24 women with twin pregnancy at 11-13 weeks of pregnancy and 20 of these women completed the study. We measured the weight gains and changes in body fat and muscle mass of these women at 22-24 weeks and 30-32 weeks of pregnancy and within one week after delivery. The body weight, body fat and muscle mass of the newborns also were measured. The body fat and muscle mass of both the mothers and babies were measured using accurate state-of-the-art methods. Gain in fat mass of the mothers was highest between 11-14 weeks and 22-24 weeks of pregnancy whereas gain in muscle mass was highest between 22-24 weeks and 30-32 weeks of pregnancy. Our results showed that higher gain in muscle mass among the mothers led to higher birth weight and length suggesting that muscle mass gain in mothers with twin pregnancy may be important for optimal outcome of the newborns.
Technical Abstract: Although the impact of gestational weight gain (GWG) on birth weight in twin pregnancies has been demonstrated, the specific components of GWG have not been delineated for twin gestations. Fetal body composition has been shown to be modifiable in singleton gestations based on nutritional intervention strategies and may prove to have similar modifications in twin gestations. We aimed to determine the relation of maternal body composition changes to birth weight, birth length, and neonatal fat mass (FM) in dichorionic-diamniotic twin pregnancies. This is a prospective study of 20 women with twin gestations. Comparisons were made between body composition variables during each trimester and for the entire pregnancy and compared with the outcomes of birth weight, neonatal fat percentage, and birth length. GWG within or above compared with below the IOM recommendations was associated with higher birth weights (P = 0.03, P = 0.04, respectively), but also with higher postpartum weight retention (P = 0.001). Total maternal protein gain over the pregnancy was positively associated with birth weight (P = 0.03). Changes in maternal fat-free mass (FFM), total body water (TBW), and FM from the first to the third trimester were not associated with either birth weight or neonatal FM percentage. However, maternal FM change from the second to the third trimester was significantly correlated to neonatal FM percentage (P = 0.02). Third trimester GWG and total protein gain were positively correlated with neonatal birth length (P = 0.02 and 0.03, respectively). Maternal FFM over all 3 trimesters showed a positive relation with neonatal birth length (P = 0.01). Significant increases in maternal protein are associated with greater birth weight and neonatal birth length. Protein accretion, in contrast to TBW and FM gains, may be the most critical component of maternal GWG in dichorionic twin gestations.