Conclusion:
With twin pregnancies already being at high risk for adverse outcomes regardless of the maternal pre-pregnancy weight, this study supports findings of other studies on the additional impact of overweight and obesity on both mother and twins. However, this study also shows a lower rate of complications in contrast to some studies mentioned afore, most likely due to the health care system in Germany and the Buergerhospital Frankfurt being a tertiary referral center with a joined NICU. This results in better and continuous monitoring from the very start of the pregnancy and thus complications being diagnosed earlier with the option to intervene sooner. Furthermore, an antibiotic prophylaxis before cesarean sections is standard in Germany and therefore also leading to lower post-cesarean maternal complications.
With increasing incidences of overweight and obesity worldwide, the associated risks for twin pregnancies need to be addressed more to create a foundation for better understanding and enhanced prevention of overweight and obesity both in general and especially in regard to pregnancies. However, underweight has also shown to have a great impact on adverse fetomaternal outcomes in twin pregnancies, implicating the need for information in this area as well.