双胎妊娠孕母孕前体重指数水平对母婴结局的影响OA

Objective To investigate the impact of maternal prepregnancy body mass index(BMI)on maternal and infant outcomes in twin pregnancies.Methods A retrospective analysis included 4 824 twin pairs and their mothers with complete records,delivered at 21 tertiary grade-A hospitals nationwide from January 2018 to December 2020.Participants were grouped by prepregnancy BMI:underweight(<18.5 kg/m²;n=566),normal weight(18.5 to<24.0 kg/m²;n=3 120),overweight(24.0 to<28.0 kg/m²;n=892),and obese(≥28.0 kg/m²;n=246).Differences and associations in adverse maternal and infant outcomes were compared among groups.Results The gestational age in the overweight group was lower than in the normal and underweight groups,with a higher rate of very preterm birth(P<0.008).Compared with the normal and overweight groups,the proportion of small-for-gestational-age(SGA)neonates was higher in the underweight group(P<0.008).After adjustment for confounders,the obese group had higher risks of gestational diabetes mellitus and hypertensive disorders of pregnancy than the normal and underweight groups(all P<0.001).Compared with the normal group,the underweight group had a higher risk of SGA among twins(P<0.05).Conclusions Maternal prepregnancy BMI is closely associated with maternal and infant outcomes in twin pregnancies,providing evidence-based support for individualized weight management.