Weight gain in twin gestations: are the Institute of Medicine guidelines optimal for neonatal outcomes?

Objective:to assess neonatal outcomes according to gestational weight gain (gwg) in twins.study design:this was a retrospective cohort study of twins delivered at ⩾24 weeks. gwg was defined using the institute of medicine (iom) guidelines as the referent. birthweight and neonatal intensive-care unit (nicu) admissions were compared with ≥2- and analysis of variance tests, stratified by body mass index (bmi).result:in all three bmi groups, mean birth weight of the larger and smaller twin increased as gwg increased, p<0.01. for the underweight/normal-weight group, both twins <2500 g, <1500 g and small for gestational age decreased significantly as gwg increased. birthweight <2500 g increased in all groups with gwg below the iom guidelines, p<0.01. in the multivariate analysis, both twins <2500 g were significantly decreased with gwg above iom guidelines. there was no difference in nicu admissions with gwg above the iom guidelines.conclusion:gwg above the iom guidelines may improve twin birth weights, with the findings most significant in underweight/normal-weight women.