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Putting Research Into Practice: What Works for Healthy Multiple Pregnancies

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

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Putting Research Into Practice: What Works for Healthy Multiple Pregnancies

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  1. 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

  2. What Works for a Healthy Multiple Pregnancy • The Basics • Influence of Obstetric History • Pre-Pregnancy Weight-for-Height • Pattern of Gestational Weight Gain • Healthy Diet • Selected Supplementation • Work and Home Factors

  3. What Works for a Healthy Multiple Pregnancy The Basics • No smoking-including anyone in the household • No alcohol use • Reduce stress at work/home • Adequate rest/sleep

  4. What Works for a Healthy Multiple Pregnancy Influence of Obstetric History • Prior, full-term, well-grown infant: adds ~two weeks • Prior preterm, low birthweight, or preeclampsia: increased risk in current pregnancy

  5. What Works for a Healthy Multiple Pregnancy Pre-Pregnancy Weight-for- Height (Body Mass Index) • If underweight (BMI<20), pattern of gain is more important • If overweight/obese, quality of the diet is more important

  6. What Works for a Healthy Multiple Pregnancy Pattern of Gestational Weight Gain • Weight gain goals by 20 and 28 weeks • Range by maternal BMI (overweight recommendations are the lower numbers, underweight are the higher numbers) By 20 weeks By 28 weeks • Twins: 15-35 lbs 23-51 • Triplets: 30-40 lbs 46-60 • Quads/Quints: 40-50 lbs 60-70

  7. What Works for a Healthy Multiple Pregnancy Healthy Diet • Protein & carbohydrate together at every meal and every snack • Eat every 3-4 hours, more often if hungry or pregnant with triplets or quads • Dairy bedtime snack (digested slowly) • Adequate hydration (urine should be pale)

  8. What Works for a Healthy Multiple Pregnancy Selected Supplementation • Folic Acid, 4 mg/day • Calcium, 1-2 g/day • Magnesium, 400-800 mg/day • Zinc, 15-30 mg/day • Vitamin D, 25-50 mcg/day (2,000-4,000IU) • Omega-3 fatty acids, 1,000 mg/day or more

  9. Timing of Delivery • For twins: 37-39 weeks • For triplets: 34-36 weeks • For quads & quints: 32-34 weeks

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