Is growth-discordance in twins a substantial risk factor in adverse neonatal outcomes?

Simonetta Frezza, Francesca Gallini, Maria Puopolo, Maria Pia De Carolis, Vito D'Andrea, Paola I. Guidone, Rita Paola Maria Luciano, Antonio Alberto Zuppa, Costantino Romagnoli

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

To evaluate whether growth discordance is an independent risk factor in the neonatal outcome of the smaller twin, all medical records of twin pregnancies delivered between 26 and 41 weeks during a 5-year period (January 2004-December 2008) were reviewed. Among the 49 selected twins, weight discordance was 15-20% in 7 infants, 21-30% in 16 infants, 31-40% in 16 infants and > 40% in 10 infants. No significant differences between the four groups were found with regards to obstetric complications and neonatal disease. Occurrence of birthweight below the 10th percentile and rate of admission to the neonatal intensive care unit significantly increased as intra-pair birthweight difference increased (p = .03). The > 40% discordant group had a significantly lower gestational age (p = .03), lower birthweight (p = .007) and a significantly higher mortality rate (4/10 versus 3/39 p = .04) in comparison with the other discordant groups. Multiple logistic regression analysis showed that birthweight was the single independent and consistent factor associated with elevated risks of mortality. For every 250 g increase in birthweight, the risk for mortality decreased by about 84% [RR 0.16(CI 0.00-0.70)]. Gestational age was the most reliable predictor for major neonatal complications. For every 1-week increase in gestational age a significant decreased risk for all outcomes was found. Discordance alone should not be considered as a predictor for adverse neonatal outcome. Neonatal outcome in discordant twins appears to be related to gestational age and birthweight rather than to the degree of discordance.
Lingua originaleEnglish
pagine (da-a)463-467
Numero di pagine5
RivistaTwin Research and Human Genetics
Volume14
DOI
Stato di pubblicazionePubblicato - 2011

Keywords

  • Pregnancy Complications
  • Risk Factors
  • Birth Weight
  • Female
  • Fetal Growth Retardation
  • Gestational Age
  • Humans
  • Infant
  • Infant Mortality
  • Infant, Newborn
  • Infant, Newborn, Diseases
  • Infant, Small for Gestational Age
  • Medical Records
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy, Twin
  • Twins

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