title: Early weight gain does not decrease the incidence of low birth weight and small for gestational age triplets in mothers with normal pre-gestational body mass index.
abstract: OBJECTIVE
  To examine if the recommended weight gain of >680 g/week during the first 24 weeks of pregnancy decreases the frequency of adverse birth weight outcomes in triplet mothers with a normal pregravid BMI.
  
  
  METHODS
  Retrospective observational study of a large sample of triplet mothers with a normal (19.8-26) pregravid BMI. Adequate, average, and inadequate weight gains were defined as >680, 500-680, and <500 g/week. Outcome measures were the incidence of >or=1 SGA infant and total triplet birth weight <4500 g.
  
  
  RESULTS
  Of the 1166 triplet mothers, 208 (17.8%) gained >680 g/week during their pregnancy. This presumed adequate weight gain did not reduce the incidence of SGA triplets or that of total birth weight <4500 g, irrespective of parity. These adverse birth weight outcomes were 2 to 3.5 times lower among multiparous compared to nulliparous mothers.
  
  
  CONCLUSIONS
  Early weight gain of >680 g/week in triplet mothers with a normal pre-pregnancy BMI is not associated with a decrease in the incidence of adverse outcomes. Weight gain recommendations in triplet pregnancies should be realistic and associated with a low risk-benefit ratio.
authors.affiliation: Department of Neonatology, Kaplan Medical Center, Rehovot, Israel. Orna_f@clalit.org.il
authors.forename: Orna
authors.initials: O
authors.lastname: Flidel-Rimon
authors.forename: Debbie J
authors.initials: DJ
authors.lastname: Rhea
authors.forename: Eric S
authors.initials: ES
authors.lastname: Shinwell
authors.forename: Louis G
authors.initials: LG
authors.lastname: Keith
authors.forename: Isaac
authors.initials: I
authors.lastname: Blickstein
mesh_terms: D015992:Body Mass Index; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011272:Pregnancy, Multiple / Q000502:physiology*; D012189:Retrospective Studies; D014310:Triplets / Q000502:physiology; D015430:Weight Gain / Q000502:physiology*