Maternal Obesity in Twin Pregnancy: The Role of Nutrition to Reduce Maternal and Fetal Complications
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Cohort Selection
2.2. Variable Collection
2.3. Statistical Analysis
3. Results
3.1. Maternal Characteristics of the Cohort
3.2. Biochemical and Hematological Parameters
3.3. Clinical Variables
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Lean (n = 20) | Obesity (n = 20) | p-Value | |
---|---|---|---|
Maternal age (years) | 37.0 [35.8; 43.0] | 36.0 [32.8; 38.5] | 0.097 a |
BMI (kg/m2) | 21.4 [20.3; 22.8] | 32.9 [31.2; 34.5] | <0.001 a |
Ethnicity | 0.999 b | ||
Caucasian | 4 (20.0%) | 4 (20.0%) | |
Latin | 16 (80.0%) | 15 (75.0%) | |
Black | 0 (0.0%) | 1 (5.0%) | |
Smoking habits | 2 (10.0%) | 1 (5.0%) | 0.999 b |
Parity | 1.5 [1.0; 2.0] | 2.0 [1.0; 3.2] | 0.173 a |
Miscarriages | 0.0 [0.0; 1.0] | 0.0 [0.0; 1.0] | 0.659 a |
Weight pre-pregnancy (kg) | 58.0 [55.0; 63.5] | 89.7 [80.8; 94.5] | <0.001 a |
Weight gain during pregnancy (kg) | 14.8 (5.9) | 8.8 (6.1) | 0.003 c |
Twin | 0.273 b | ||
Dichorionic diamniotic | 13 (65.0%) | 17 (85.0%) | |
Monochorionic diamniotic | 7 (35.0%) | 3 (15.0%) | |
Assisted reproduction techniques | 14 (70.0%) | 3 (15.0%) | 0.001 b |
Trimester 1 | Trimester 3 | p-Value 3 | |||||
---|---|---|---|---|---|---|---|
Lean (n = 17) | Obesity (n = 15) | p-Value 1 | Lean (n = 20) | Obesity (n = 19) | p-Value 2 | ||
Glucose (mg/dL) | 78.2 (7.50) | 82.7 (6.60) | 0.096 a | 75.7 (7.50) | 75.9 (7.90) | 0.932 a | 0.438 |
Hemoglobin (g/dL) | 12.6 (0.70) | 12.1 (0.80) | 0.048 a | 12.3 (1.00) | 12.3 (0.80) | 0.858 a | 0.224 |
Fibrinogen (mg/dL) | 494.1 (101.8) | 592.5 (182.2) | 0.373 a | 604.5 [580.8; 650.8] | 651.0 [590.0; 708.0] | 0.190 b | 0.905 |
Ferritin (g/mL) | 22.0 [14.5; 31.5] | 15.5 [10.0; 37.2] | 0.565 b | 24.0 [15.5; 32.0] | 19.0 [16.0; 29.0] | 0.884 b | 0.145 |
TSH (mUI/L) | 1.30 (1.10) | 2.20 (1.30) | 0.051 a | 1.70 (1.00) | 3.30 (1.60) | 0.009 a | 0.048 |
Vitamin D (ng/mL) | 20.7 (8.40) | 13.0 (6.40) | 0.070 a | 21.6 (5.70) | 17.4 (7.30) | 0.323 a | 0.675 |
Hematocrit (%) | 38.0 (2.1) | 37.4 (2.10) | 0.469 a | 37.4 [35.8; 38.7] | 37.1 [35.5; 39.0] | 0.725 b | 0.919 |
Platelets (106/mL) | 245.0 [201.5; 267.5] | 289.0 [241.0; 331.0] | 0.056 b | 206.5 [188.5; 250.5] | 253.0 [204.0; 309.0] | 0.074 b | 0.912 |
Leukocytes (106/mL) | 8.90 (1.90) | 8.80 (2.20) | 0.892 a | 8.90 [8.10; 9.10] | 8.50 [7.80; 1.10] | 0.955 b | 0.703 |
Lymphocytes (103/μL) | 2.13 (0.82) | 2.22 (0.66) | 0.737 a | 1.96 (0.59) | 2.28 (0.57) | 0.091 a | 0.588 |
Neutrophils (103/μL) | 6.00 (1.42) | 5.66 (1.61) | 0.546 a | 5.87 (1.04) | 6.04 (1.43) | 0.670 a | 0.689 |
Monocytes (103/μL) | 0.49 (0.16) | 0.48 (0.13) | 0.860 a | 0.49 [0.43; 0.60] | 0.44 [0.38; 0.60] | 0.800 b | 0.515 |
Eosinophils (103/μL) | 0.08 [0.06; 0.20] | 0.12 [0.09; 0.24] | 0.183 b | 0.10 [0.07; 0.14] | 0.10 [0.07; 0.21] | 0.473 b | 0.943 |
Basophils (103/μL) | 0.03 [0.02; 0.04] | 0.03 [0.03; 0.05] | 0.410 b | 0.03 [0.02; 0.04] | 0.03 [0.02; 0.05] | 0.689 b | 0.555 |
Lean (n = 20) | Obesity (n = 20) | p-Value | |
---|---|---|---|
Maternal complications | |||
Preeclampsia | 4 (20.0%) | 2 (10.0%) | 0.661 a |
Pregnancy-induced hypertension | 1 (5.0%) | 5 (25.0%) | 0.182 a |
Gestational diabetes mellitus | 1 (5.0%) | 4 (20.0%) | 0.342 a |
Anemia | 18 (90.0%) | 15 (75.0%) | 0.407 a |
Urinary infection | 1 (5.0%) | 2 (10.0%) | 0.999 a |
Fetal complications | |||
Intrauterine growth restriction–Fetus 1 | 0 (0.0%) | 2 (10.0%) | 0.487 a |
Intrauterine growth restriction–Fetus 2 | 2 (10.0%) | 1 (5.0%) | 0.999 a |
Malformations–Fetus 1 | 3 (15.0%) | 0 (0.0%) | 0.231 a |
Malformations–Fetus 2 | 3 (15.0%) | 2 (10.0%) | 0.999 a |
Obstetrical complications | |||
Premature rupture of membrane | 1 (5.0%) | 4 (20.0%) | 0.342 a |
Threat of premature labor | 1 (5.0%) | 2 (10.0%) | 0.999 a |
C-section | 13 (65.0%) | 16 (80.0%) | 0.479 a |
Puerperal hemorrhage | 1 (5.0%) | 1 (5.0%) | 0.999 a |
Neonatal variables and complications | |||
Gestational age (weeks) | 37.5 [36.5; 38.0] | 37.1 [35.0; 37.4] | 0.083 b |
Prematurity | 6 (30.0%) | 9 (45.0%) | 0.514 a |
Birth body weight-neonate 1 (g) | 2400.0 [2216.2; 2712.5] | 2467.5 [1867.0; 3011.2] | 0.705 b |
LBW-neonate 1 | 2 (10.0%) | 6 (30.0%) | 0.235 a |
Birth body weight-neonate 2 (g) | 2602.5 [2098.8; 2783.8] | 2500.0 [2141.2; 2887.5] | 0.725 b |
LBW-neonate 2 | 3 (15.0%) | 4 (20.0%) | 0.999 a |
Apgar 5 min-neonate 1 | 10.0 [9.0; 10.0] | 10.0 [9.0; 10.0] | 0.890 b |
Apgar 5 min-neonate 2 | 10.0 [9.0; 10.0] | 10.0 [9.0; 10.0] | 0.436 b |
Artery pH-neonate 1 | 7.3 [7.3; 7.3] | 7.3 [7.3; 7.3] | 0.211 b |
Artery pH-neonate 2 | 7.3 [7.3; 7.3] | 7.3 [7.3; 7.3] | 0.507 b |
NICU admission-neonate 1 | 8 (40.0%) | 8 (40.0%) | 0.999 a |
RDS-neonate 1 | 1 (5.0%) | 4 (20.0%) | 0.342 a |
NICU admission-neonate 2 | 8 (40.0%) | 7 (35.0%) | 0.999 a |
RDS-neonate 2 | 3 (15.0%) | 4 (20.0%) | 0.999 a |
Neonatal death | 0 (0.0%) | 1 (5.0%) | 0.999 a |
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de la Calle, M.; Bartha, J.L.; Marín, C.; Rus, J.C.; Córcoles, G.; Ruvira, S.; Ramiro-Cortijo, D. Maternal Obesity in Twin Pregnancy: The Role of Nutrition to Reduce Maternal and Fetal Complications. Nutrients 2022, 14, 1326. https://doi.org/10.3390/nu14071326
de la Calle M, Bartha JL, Marín C, Rus JC, Córcoles G, Ruvira S, Ramiro-Cortijo D. Maternal Obesity in Twin Pregnancy: The Role of Nutrition to Reduce Maternal and Fetal Complications. Nutrients. 2022; 14(7):1326. https://doi.org/10.3390/nu14071326
Chicago/Turabian Stylede la Calle, María, Jose L. Bartha, Clara Marín, Juan Carlos Rus, Guillermo Córcoles, Santiago Ruvira, and David Ramiro-Cortijo. 2022. "Maternal Obesity in Twin Pregnancy: The Role of Nutrition to Reduce Maternal and Fetal Complications" Nutrients 14, no. 7: 1326. https://doi.org/10.3390/nu14071326