What is known about gestational weight gain in Chinese twin pregnancies? A scoping review

The number of twin pregnancies has gradually increased over the last three decades. Twin pregnancies are more prone to pregnancy-related complications for both mother and baby. Gestational weight gain is an important modifiable factor in optimising adverse pregnancy outcomes. However, there is a gap in the range of gestational weight gain for twin pregnancies in China. Therefore, this scoping review aims to synthesise the existing evidence on the optimal range of gestational weight gain for twin pregnancies in China and the association between perinatal outcomes and gestational weight gain.

A scoping review of research on gestational weight gain in Chinese twins up to 2024 was undertaken. Studies for review were identified through systematic searches of three English electronic databases (PubMed, Embase, and Web of Science) and three Chinese databases (CNKI, Wanfang, and SinoMed). Studies were included if they investigated weight gain during pregnancy in Chinese twin pregnant women. Data were extracted, tabulated, and analysed comprehensively. Literature selection and data extraction were performed independently by two reviewers.

Twelve studies proposed recommended ranges for Chinese twin pregnant women using the interquartile range method. Most of these gestational weight gain ranges were lower than the 2009 IOM guidelines. Eight studies validated the plausibility of gestational weight gain by comparing the risk of maternal and neonatal outcomes within and outside the recommended range. Seven of them found that their proposed gestational weight gain ranges were appropriate for Chinese women with twin pregnancies, as adverse perinatal outcomes were at increased risk when weight gain was outside the proposed range.

There is no consensus on the optimal range of weight gain for Chinese twin pregnant women. As a next step, researchers should reach a consensus on gestational weight gain by conducting a multicentre and large-sample study and then explore interventions to control inappropriate weight gain to help pregnant women avoid adverse perinatal outcomes.