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Neonatal morbidity in growth-discordant monochorionic twins: comparison between the larger and the smaller twin.
MedLine Citation:
PMID:  22854118     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Fetal growth restriction in singletons has been shown to enhance fetal lung maturation and reduce the risk of respiratory distress syndrome due to increased endogenous steroid production. However, data on lung maturation in growth-discordant monochorionic (thus, identical) twins are lacking. Our objective was to compare the risk of severe neonatal morbidity between the larger and the smaller twin in monochorionic twins with birth weight discordance (BWD). We included in the study all consecutive monochorionic diamniotic pregnancies with severe BWD (≥25%) and two live-born twins delivered at our center (n = 47 twin pairs). We compared the incidence of neonatal morbidity, particularly respiratory distress syndrome (RDS), and cerebral lesions between the larger and the smaller co-twin. The incidence of severe neonatal morbidity in the larger and smaller twin was 38% (18/47) and 19% (9/47), respectively (odds ratio (OR) 2.66, 95% confidence interval (CI) 0.94-7.44) and was due primarily to the higher incidence of RDS, 32% (15/47) and 6% (3/47), respectively (OR 6.88, 95% CI 1.66-32.83). In conclusion, this study shows that the larger twin in monochorionic twin pairs with BWD is at increased risk of severe neonatal morbidity, particularly RDS, compared to the smaller twin.
Authors:
Enrico Lopriore; Carolien Sluimers; Suzanne A Pasman; Johanna M Middeldorp; Dick Oepkes; Frans J Walther
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Twin research and human genetics : the official journal of the International Society for Twin Studies     Volume:  15     ISSN:  1832-4274     ISO Abbreviation:  Twin Res Hum Genet     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101244624     Medline TA:  Twin Res Hum Genet     Country:  England    
Other Details:
Languages:  eng     Pagination:  541-6     Citation Subset:  IM    
Affiliation:
Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
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