(742) Utility of prenatal nutrition consult in achieving recommended weight gain in diamniotic twin pregnancies

Objective: To determine if prenatal nutrition counseling affected maternal weight gain and birth outcomes in diamniotic pregnancies

Study Design: A retrospective cohort of diamniotic twin pregnancies cared for by maternal-fetal medicine specialists at one academic institution from January 2021 to December 2022 was collected. Patients were grouped based on whether they received a nutrition consult or not. Institute of Medicine (IOM) goals for twin pregnancies were used to determine appropriate weight gain based on pre-gravid BMI. Comparisons were performed with Chi-square, t-tests, and multivariable logistic regression adjusted for characteristics that were significantly associated with the outcome.

Results: Our cohort included 109 patients with and 70 without a nutrition consult. The rate of monochorionicity was significantly higher in the nutrition group at 49 versus 13% (p< 0.001). The mean pre-gravid BMI was significantly lower in the nutrition group (26 vs. 28.9, p=0.006). The groups were otherwise similar (Table 1).
Nutrition consult was associated with a significantly higher mean total weight gain (17.9 vs. 13.4 kg, p< 0.001) and a significantly higher rate of meeting IOM goals (59 vs. 29%, p=0.003). Mean gestational age at delivery was 5.6 days later in the nutrition group (p=0.04). When adjusted for age, race, parity, marital status, pregravid BMI, and chorionicity, those who did not receive a nutrition consult had over doubled odds of delivery < 34 weeks (aOR 2.65, 95% CI 1.12-6.23) and of a very low birthweight neonate (aOR 2.34, 95% CI 1.19-4.62) (Table 2).

Conclusion: Prenatal nutrition consult in diamniotic twin pregnancies resulted in a significantly higher proportion of patients meeting IOM weight gain goals, later gestational age at delivery with significantly fewer births before 34 weeks, and lower risk of very low birthweight neonates. This supports the importance of prenatal nutrition consult for twin pregnancies.