Maternal weight gain in twin-twin transfusion syndrome

To examine the association between maternal weight gain and twin-twin transfusion syndrome (TTTS).

Retrospective observational study in two tertiary care centers.

All 124 women with monochorionic diamniotic twin pregnancies who gave birth at ≥ 16 gestational weeks between 2002 and 2010.

Analysis of chronological relation between maternal weight gain per week (weekly gain) and the diagnosis of TTTS.

Sonographic diagnosis of TTTS.

A weekly weight gain ≥ 1.4 kg occurred in 45 women, preceded the diagnosis of TTTS in 22 (78.6%) of the 28 women with TTTS, and was associated with TTTS [women with one weekly weight gain ≥ 1.4 kg vs. women with no weekly weight gains ≥1.4 kg who were diagnosed as having TTTS: 48.9% (22/45) vs. 7.6% (6/79); RR, 6.44; 95%CI, 2.82-14.69]. At given gestational weeks between 16 and 27, the mean (± SD) prospective risk of the development of TTTS within three weeks was 52.0 ± 33.8% among women who showed a weekly weight gain ≥ 1.4 kg for the first time, whereas the risk of the development of TTTS within one week was 1.6 ± 1.7% among women who never showed a weekly weight gain ≥ 1.4 kg.

Excessive maternal weight gain ≥ 1.4 kg/week is likely to occur during the development of TTTS.