putting research into practice: what works for healthy multiple pregnancies

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Putting Research Into Practice: What Works for Healthy Multiple Pregnancies Barbara Luke, ScD, MPH Presented at the International Society for Twin Studies, Florence, Italy, March, 2012

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Putting Research Into Practice: What Works for Healthy Multiple Pregnancies. Barbara Luke, ScD, MPH Presented at the International Society for Twin Studies, Florence, Italy, March, 2012 . What Works for a Healthy Multiple Pregnancy. The Basics Influence of Obstetric History - PowerPoint PPT Presentation

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Page 1: Putting Research Into Practice:  What Works for  Healthy Multiple Pregnancies

Putting Research Into Practice:

What Works for Healthy Multiple Pregnancies

Barbara Luke, ScD, MPHPresented at the

International Society for Twin Studies,Florence, Italy, March, 2012

Page 2: Putting Research Into Practice:  What Works for  Healthy Multiple Pregnancies

What Works for a Healthy Multiple Pregnancy

1. The Basics2. Influence of Obstetric History3. Pre-Pregnancy Weight-for-Height4. Pattern of Gestational Weight Gain5. Healthy Diet6. Selected Supplementation7. Work and Home Factors

Page 3: Putting Research Into Practice:  What Works for  Healthy Multiple Pregnancies

What Works for a Healthy Multiple Pregnancy

The BasicsONo smoking-including anyone in

the householdONo alcohol useOReduce stress at work/homeOAdequate rest/sleep

Page 4: Putting Research Into Practice:  What Works for  Healthy Multiple Pregnancies

What Works for a Healthy Multiple Pregnancy

Influence of Obstetric HistoryOPrior, full-term, well-grown

infant: adds ~two weeksOPrior preterm, low

birthweight, or preeclampsia: increased risk in current pregnancy

Page 5: Putting Research Into Practice:  What Works for  Healthy Multiple Pregnancies

What Works for a Healthy Multiple Pregnancy

Pre-Pregnancy Weight-for- Height (Body Mass Index)

OIf underweight (BMI<20), pattern of gain is more importantOIf overweight/obese, quality of the diet is more important

Page 6: Putting Research Into Practice:  What Works for  Healthy Multiple Pregnancies

What Works for a Healthy Multiple Pregnancy

Pattern of Gestational Weight GainOWeight gain goals by 20 and 28 weeksORange by maternal BMI (overweight recommendations are the lower numbers, underweight are the higher numbers)

By 20 weeks By 28 weeksOTwins: 15-35 lbs 23-51OTriplets: 30-40 lbs 46-60OQuads/Quints: 40-50 lbs 60-70

Page 7: Putting Research Into Practice:  What Works for  Healthy Multiple Pregnancies

What Works for a Healthy Multiple Pregnancy

Healthy DietOProtein & carbohydrate together at every meal and every snackOEat every 3-4 hours, more often if hungry or pregnant with triplets or quadsODairy bedtime snack (digested slowly)OAdequate hydration (urine should be pale)

Page 8: Putting Research Into Practice:  What Works for  Healthy Multiple Pregnancies

What Works for a Healthy Multiple Pregnancy

Selected SupplementationOFolic Acid, 4 mg/dayOCalcium, 1-2 g/dayOMagnesium, 400-800 mg/dayOZinc, 15-30 mg/dayOVitamin D, 25-50 mcg/day (2,000-4,000IU)OOmega-3 fatty acids, 1,000 mg/day or more

Page 9: Putting Research Into Practice:  What Works for  Healthy Multiple Pregnancies

Timing of Delivery

OFor twins: 37-39 weeksOFor triplets: 34-36 weeksOFor quads & quints: 32-34 weeks