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Nutritional Intake in Dichorionic Twin Pregnancies: A Descriptive Analysis of a Multisite United States Cohort

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Abstract

Introduction

Twin gestations have greater nutritional demands than singleton gestations, yet dietary intakes of women with twin gestations have not been well described.

Methods

In a prospective, multi-site US study of 148 women with dichorionic twin gestations (2012–2013), we examined longitudinal changes in diet across pregnancy. Women completed a food frequency questionnaire during each trimester of pregnancy. We examined changes in means of total energy and energy-adjusted dietary components using linear mixed effects models.

Results

Mean energy intake (95% CI) across the three trimesters was 2010 kcal/day (1846, 2175), 2177 kcal/day (2005, 2349), 2253 kcal/day (2056, 2450), respectively (P = 0.01), whereas the Healthy Eating Index-2010 was 63.9 (62.1, 65.6), 64.5 (62.6, 66.3), 63.2 (61.1, 65.3), respectively (P = 0.53).

Discussion

Women with twin gestations moderately increased total energy as pregnancy progressed, though dietary composition and quality remained unchanged. These findings highlight aspects of nutritional intake that may need to be improved among women carrying twins.

Significance

What is Already Known about the Subject? Twin pregnancies have higher nutritional demands than singleton pregnancies. However, studies with longitudinal dietary data examining if, how, and at what points during gestation women may change their diets to support twin pregnancies have not been available.

What this Study adds? Though total energy intake increased statistically significantly from the first to the third trimester, other aspects of diet remained stable across gestation. Similar to singleton pregnancies, diet quality was suboptimal among women pregnant with twins.

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Fig. 1

Data and code Availability

The data and codebook, along with a set of guidelines for researchers applying for the data, will be posted in the future to a data-sharing site, the NICHD/DIPHR Biospecimen Repository Access and Data Sharing [https://brads.nichd.nih.gov] (BRADS). The analytic code for this manuscript is available upon request.

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Acknowledgements

The authors acknowledge the research teams at all the participating clinical centers, including Christina Care Health Systems; University of California, Irvine; Long Beach Memorial Medical Center; Northwestern University; Medical University of South Carolina; Columbia University; University of Alabama at Birmingham; and Women and Infants Hospital of Rhode Island.

Funding

This work was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), supplemented by funding from the NIH Office of Dietary Supplements and the American Recovery and Reinvestment Act. Contracts: HHSN275200800013C, HHSN275200800002I, HHSN27500006, HHSN275200800003IC, HHSN275200800014C, HHSN275200800012C, HHSN275200800028C, and HHSN275201000009C.

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Authors and Affiliations

  1. Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA

    Samrawit F. Yisahak, Katherine L. Grantz & Jagteshwar Grewal

  2. Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Stefanie N. Hinkle & Sunni L. Mumford

  3. Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Cuilin Zhang

  4. NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality, National University of Singapore, Singapore, Singapore

    Cuilin Zhang

  5. Division of Maternal-Fetal Medicine, Medical University of South Carolina, Charleston, SC, USA

    Roger B. Newman

  6. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    William A. Grobman

  7. Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA

    Paul S. Albert

  8. Christiana Care Health System, Wilmington, DE, USA

    Anthony Sciscione

  9. University of California, Irvine and Long Beach Memorial Medical Center, Long Beach, CA, USA

    Deborah A. Wing

  10. University of Alabama at Birmingham, Birmingham, AL, USA

    John Owen

  11. Women and Infants Hospital of Rhode Island, Providence, RI, USA

    Edward K. Chien

  12. College of Health and Human Services, George Mason University, Fairfax, VA, USA

    Germaine M. Buck Louis

Authors
  1. Samrawit F. Yisahak
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  2. Stefanie N. Hinkle
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  3. Sunni L. Mumford
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  4. Katherine L. Grantz
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  14. Jagteshwar Grewal
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Contributions

GMB, JG, KLG, PSA, CZ, AS, DAW, WAG, RBN, DS, MPN, ACR, JO, EKC, and SC led the cohort design and data collection; SFY, SNH, SLM, and JG designed the project conception and development of the overall research plan; SFY analyzed the data and wrote the first draft of the paper; PSA provided guidance on the analytic design and approach; all authors read the manuscript, interpreted the results, provided critical intellectual content, and approved of the final manuscript. SFY and JG had primary responsibility for final content.

Corresponding author

Correspondence to Jagteshwar Grewal.

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Conflict of interest

The authors declare that they have no conflict of interest. SFY, SNH, JG, SLM, KLG, PSA, and CZ are employees of the U.S. Federal Government.

Ethics Approval

Ethical approval was obtained from the Institutional Review Boards of NICHD, the clinical sites, and the data and imaging coordinating centers. Participants provided written informed consent.

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Yisahak, S.F., Hinkle, S.N., Mumford, S.L. et al. Nutritional Intake in Dichorionic Twin Pregnancies: A Descriptive Analysis of a Multisite United States Cohort. Matern Child Health J 28, 206–213 (2024). https://doi.org/10.1007/s10995-023-03802-5

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  • DOI: https://doi.org/10.1007/s10995-023-03802-5

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