Intrauterine growth pattern and birthweight discordance in twin pregnancies: a retrospective study

Italian Journal of Pediatrics

Giovanni Corsello¹  Valentina Malerba¹  Ettore Piro¹  Maria Piccione¹  Mario Giuffré¹  Giuseppe Puccio¹ 

[1] Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università degli Studi di Palermo, Palermo, Italy

关键词: Neonatal anemia;    Weight percentile;    SGA;    Birthweight discordance;    Twins;   

Others  :  802386
DOI  :  10.1186/1824-7288-40-43

 received in 2013-12-19, accepted in 2014-04-25,  发布年份 2014

【 摘 要 】

Background

Twins, compared to singletons, have an increased risk of perinatal mortality and morbidity, due mainly to a higher prevalence of preterm birth and low birthweight. Intrauterine growth restriction (IUGR) is also common and can affect one or both fetuses. In some cases, however, one twin is much smaller than the other (growth discordance). Usually, high birthweight discordance is associated with increased perinatal morbidity. The aim of this study is to describe the epidemiological features of a population of twins at birth, with particular reference to the interpretation and clinical effects of birthweight discordance.

Methods

We evaluated retrospectively the clinical features of 70 infants born from twin pregnancies and assessed birthweight discordance in 31 pregnancies where both twins were followed at our institution. Discordance was treated both as a continuous and a categorical variable, using a cutoff of 18%. Possible relationships between birthweight discordance and other variables, such as maternal age, gestational age, birthweight percentile, number of SGA newborns in the pair, Hematocrit (Ht) discordance and neonatal anemia, prevalence of malformations, neonatal morbidity and death, were analyzed.

Results

In our cohort birthweight percentile decreased slightly with increasing gestational age. Birthweight discordance, on the contrary, increased slightly with the increase of gestational age.

A high discordance is associated to the presence of one SGA twin, with the other AGA or LGA. In our population, all 6 pregnancies in which discordance exceeded 18% belonged to this category (one SGA twin).

Ht discordance at birth is associated to the presence of neonatal anemia in a twin, but it is not significantly related to weight discordance.

Finally, in our case history, weight discordance is not associated in any way with the prevalence of malformations, morbidity and mortality.

Conclusions

Birthweight discordance is an important indicator of complications that act asymmetrically on the two fetuses, affecting intrauterine growth in one of them, and usually determining the birth of a SGA infant.

Our case history shows a significant statistical association between pair discordance and IUGR in one of the twins, but we could not demonstrate any relationship between discordance and the prevalence of malformations, morbidity and mortality.

【 授权许可】

   
2014 Puccio et al.; licensee BioMed Central Ltd.

【 图 表 】

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