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

Objective: Nutritional education in twin gestations improves perinatal outcomes. Our objective was to determine if a prenatal nutrition consultation led to more patients with diamniotic twin pregnancies achieving adequate weight gain according to Institute of Medicine (IOM) guidelines. Study Design: We collected a retrospective cohort of diamniotic twin pregnancies cared for by maternal-fetal medicine specialists at one academic institution from January 2021 to December 2022. Patients were grouped based on whether they received at least one outpatient nutrition consult and these groups were compared based on whether they met weight gain guidelines or not and other perinatal outcomes. Analyses were performed with Chi-square, t-tests, and multivariable logistic regression adjusted for characteristics that were significantly associated with each outcome. Results: Nutrition consultation was associated with a significantly higher rate of meeting IOM goals (59 vs. 29%, p=0.003) and a significantly higher mean total weight gain (17.9 vs. 13.4 kg, p< 0.001). 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, pre-gravid BMI, and chorionicity, those who did not receive a nutrition consult had over doubled odds of delivery before 34 weeks (aOR 2.65, 95% CI 1.12-6.23). Conclusion: One prenatal nutrition consult in diamniotic twin pregnancies resulted in a significantly higher proportion of patients meeting IOM weight gain goals and significantly fewer births before 34 weeks.