Document Detail


Growth restriction as a determinant of outcome in preterm discordant twins.
MedLine Citation:
PMID:  15625146     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To estimate the influence of intrauterine growth restriction (IUGR) on the outcome of preterm discordant twins. METHODS: Medical records of preterm twins born at 24-34 weeks of gestation between 1995 and 2000 were reviewed. Significant discordancy was defined as more than 15% difference in birth weight. Small for gestational age (SGA) was defined as birth weight less than 10th percentile, according to a twin-adjusted gestational age nomogram. The smaller twins of 96 discordant twin pairs were evaluated. The SGA-discordant group included the smaller twin of a discordant pair who was also SGA (n = 46); the appropriate-for-gestational-age (AGA)-discordant group included the smaller twin of a discordant pair who was appropriate for gestational age (n = 50). RESULTS: Maternal age, incidence of maternal hypertension, antenatal steroids, and gestational age at delivery were similar between groups. Delivery for suspected fetal compromise complicated significantly more pregnancies in the SGA-discordant group than in the AGA-discordant group (45.6% versus 16%, P = .005), as did respiratory distress syndrome (RDS) (37% versus 8%, P < .05) and intraventricular hemorrhage (21.7% versus 6%, P = .024). Mortality or severe neonatal morbidity (defined as severe RDS, intraventricular hemorrhage grades 3-4, or necrotizing enterocolitis) were significantly higher among neonates in the SGA-discordant group than in the AGA-discordant group (19.5% versus 6%, P = .04). The risk for major morbidity was 7.7-fold greater in the SGA-discordant than in the AGA-discordant group, adjusted for gestational age. CONCLUSION: Growth restriction in preterm discordant twins is associated with a 7.7-fold increased risk for major neonatal morbidity. Therefore, discordant twins with IUGR require closer monitoring than discordant twins without IUGR.
Authors:
Yoav Yinon; Ram Mazkereth; Naomi Rosentzweig; Avital Jarus-Hakak; Eyal Schiff; Michal J Simchen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  105     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2004-12-30     Completed Date:  2005-02-08     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  80-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel. yinony@barak-online.net
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MeSH Terms
Descriptor/Qualifier:
Diseases in Twins*
Female
Fetal Growth Retardation / complications,  genetics*
Gestational Age
Humans
Infant, Newborn
Infant, Premature, Diseases / etiology,  genetics*
Infant, Small for Gestational Age
Pregnancy
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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