title: Optimal weight gain in triplet pregnancies.
abstract: To identify appropriate weight gain in triplet gestations, which may aid in reducing the risk of perinatal morbidity within this high-risk cohort.
  
  
  
  This retrospective cohort study evaluated all non-anomalous triplet pregnancies between 23 and 40 weeks' gestation resulting in live births at five tertiary-care medical centers between 1991 and 2011. Subjects were divided by pre-pregnancy BMI into underweight, normal-weight, overweight, and obese groups, and then stratified by low (<0.5 lb/week), moderate (0.5-1.49 lbs/week), or excess weight gain (≥1.5 lbs/week). Primary outcomes included spontaneous preterm birth and preeclampsia.
  
  
  
  We included 116 mothers and 348 corresponding neonates for final analysis. The incidence of preeclampsia and preterm delivery less than 32 weeks' gestation was 37% and 41%, respectively. The incidence of preeclampsia increased with weight gain per week, but was not statistically different from subjects who gained less weight. We found no statistical correlation between weight gain per week and preterm delivery.
  
  
  
  We found no association between preeclampsia or preterm delivery and increasing weight gain in triplet pregnancies. The association with increased risk for preeclampsia was predominantly due to BMI effect. Based on the current study, recommendations for optimal weight gain in mothers with triplet gestations could not be defined.
authors.affiliation: b Department of Obstetrics and Gynecology , Baylor College of Medicine & Texas Children's Hospital , Houston , TX , USA.
authors.forename: Amir A
authors.initials: AA
authors.lastname: Shamshirsaz
authors.affiliation: b Department of Obstetrics and Gynecology , Baylor College of Medicine & Texas Children's Hospital , Houston , TX , USA.
authors.forename: Alireza A
authors.initials: AA
authors.lastname: Shamshirsaz
authors.affiliation: c School of Medicine, University of Connecticut , Farmington , CT , USA.
authors.forename: Sam F
authors.initials: SF
authors.lastname: Ravangard
authors.affiliation: e Stony Brook School of Medicine , Stony Brook , NY , USA , and.
authors.forename: M Baraa
authors.initials: MB
authors.lastname: Allaf
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D059286:Pregnancy, Triplet / Q000502:physiology*; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D015430:Weight Gain; D055815:Young Adult
keywords: Weight gain; high-risk pregnancy; historical cohort study; pre-eclampsia; triplet pregnancy