THE IDEAL TWIN PREGNANCY - PATTERNS OF WEIGHT-GAIN, DISCORDANCY, AND LENGTH OF GESTATION

OBJECTIVE: Our purpose was to evaluate factors associated with the bes t intrauterine growth and lowest morbidity among twins (''ideal twin p regnancy''). STUDY DESIGN: A historic prospective study of 163 twin bi rths was performed. Ten models were formulated with multiple regressio n and multivariate logistic regression. RESULTS: In the models of birt h weight, gestations of 28 to 36 and 39 to 41 weeks, black race, great er-than-or-equal-to 15% discordancy, and smoking were all significant negative factors. The pattern of early low weight gain (< 0.85 pounds per week before 24 weeks) and late low weight gain (< 1.0 pound per we ek after 24 weeks) was negatively associated with all eight models of intrauterine growth. CONCLUSIONS: The best intrauterine growth and low est morbidity is achieved earlier for twins than for singletons. Using length of stay and growth retardation critera, nearly 70% of ''ideal' ' twin pregnancies were between 35 and 38 weeks. In addition, poor wei ght gain and poor patterns of weight gain were associated with all mea sures of intrauterine growth and adverse pregnancy outcomes.