The birth rate for multiples has recently increased by 46%. Twins and triplets are at increased risk for preterm delivery and low birth weight. Women with a multiple gestation are treated with antepartum bed rest to reduce low birth weight and preterm birth, even though this treatment is not known to be effective. Furthermore, bed rest treatment is associated with numerous maternal side effects including maternal weight loss, symptoms of musculoskeletal and cardiovascular deconditioning, increased stress and depression, later postpartum recovery, and lower infant birth weight. However, no study has specifically identified those side effects of bed rest treatment that are alone associated with multiple gestation. The purpose of this longitudinal repeated measures study was to identify the antepartum and side effects of bed rest treatment for 31 hospitalized women with a twin or triplet gestation. Maternal weight gain by body mass Index (BMI) was determined using the same scale. Multiple Gestations: Side Effects of Antepartum Bed Rest Antepartum and postpartum symptoms of bed rest were assessed by the Antepartum and Postpartum Symptom Checklists. Infant birth weights were compared with current 1994-1996 US reference for weights of twins and triplets by gestational age, and gender. Antepartum stressors was measured by the Antepartum Stressors Hospital Inventory. Depressive symptoms were measured by the Multiple Affect Adjective Checklist Revised (MAACL-R) Dysphoria and the Center for Epidemiologic Studies Depression Scale (CES-D). Weekly maternal weight gain during hospitalization was less than Institute of Medicine recommendations. Infant birth weights were appropriate for gestational age. Maternal stress remained high across hospitalization while maternal depression which was initially high and then decreased through six weeks postpartum. Women exhibited symptoms of musculoskeletal and cardiovascular deconditioning during the antepartum which began to recover during the postpartum. Antepartum interventions and postpartum rehabilitation is needed to prevent and treat side effects of antepartum bed rest.
Session #1206 - Childbearing
The 29th Annual MNRS Research Conference (April 1-4, 2005)