Putting Research Into Practice: What Works for Healthy Multiple Pregnancies Barbara Luke, ScD, MPH Presented at the International Society for Twin Studies, Florence, Italy, March, 2012
Feb 11, 2016
Putting Research Into Practice:
What Works for Healthy Multiple Pregnancies
Barbara Luke, ScD, MPHPresented at the
International Society for Twin Studies,Florence, Italy, March, 2012
What Works for a Healthy Multiple Pregnancy
1. The Basics2. Influence of Obstetric History3. Pre-Pregnancy Weight-for-Height4. Pattern of Gestational Weight Gain5. Healthy Diet6. Selected Supplementation7. Work and Home Factors
What Works for a Healthy Multiple Pregnancy
The BasicsONo smoking-including anyone in
the householdONo alcohol useOReduce stress at work/homeOAdequate rest/sleep
What Works for a Healthy Multiple Pregnancy
Influence of Obstetric HistoryOPrior, full-term, well-grown
infant: adds ~two weeksOPrior preterm, low
birthweight, or preeclampsia: increased risk in current pregnancy
What Works for a Healthy Multiple Pregnancy
Pre-Pregnancy Weight-for- Height (Body Mass Index)
OIf underweight (BMI<20), pattern of gain is more importantOIf overweight/obese, quality of the diet is more important
What Works for a Healthy Multiple Pregnancy
Pattern of Gestational Weight GainOWeight gain goals by 20 and 28 weeksORange by maternal BMI (overweight recommendations are the lower numbers, underweight are the higher numbers)
By 20 weeks By 28 weeksOTwins: 15-35 lbs 23-51OTriplets: 30-40 lbs 46-60OQuads/Quints: 40-50 lbs 60-70
What Works for a Healthy Multiple Pregnancy
Healthy DietOProtein & carbohydrate together at every meal and every snackOEat every 3-4 hours, more often if hungry or pregnant with triplets or quadsODairy bedtime snack (digested slowly)OAdequate hydration (urine should be pale)
What Works for a Healthy Multiple Pregnancy
Selected SupplementationOFolic Acid, 4 mg/dayOCalcium, 1-2 g/dayOMagnesium, 400-800 mg/dayOZinc, 15-30 mg/dayOVitamin D, 25-50 mcg/day (2,000-4,000IU)OOmega-3 fatty acids, 1,000 mg/day or more
Timing of Delivery
OFor twins: 37-39 weeksOFor triplets: 34-36 weeksOFor quads & quints: 32-34 weeks