| Significance of Growth Discordance in Appropriately Grown Twins. | |
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MedLine Citation:
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PMID: 23369936 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the perinatal risks associated with growth discordance in appropriately grown twin gestations. STUDY DESIGN: Retrospective cohort study of all twin gestations excluding those complicated by monoamnionicity, twin-twin transfusion syndrome, structural anomalies, selective reduction, or a birth weight <10(th) percentile. Growth discordance was defined as ≥20%. Outcomes considered were stillbirth, preterm delivery <34 weeks and <28 weeks, and admission to the neonatal intensive care unit. Analyses were stratified by chorionicity. RESULTS: Of 895 included dichorionic pregnancies, 63 (7.0%) were discordant. Discordant dichorionic twins were not at increased risk of preterm delivery <34 weeks (34.9% vs 25.6%, relative risk (RR) 1.4, 95% confidence interval (CI) 1.0-1.9), preterm delivery <28 weeks (3.2% vs 2.8%, RR 1.1, 95% CI 0.3-4.8), or admission to intensive care (26.9% vs 23.5%, RR 1.5, 95% CI 1.0-2.3). We had > 90% power to detect a 2.5-fold increase in preterm delivery and admission to the neonatal intensive care unit in dichorionic twins. Of 250 monochorionic pregnancies, 23 (9.2%) were discordant. Monochorionic twin pregnancies were at increased risk of preterm delivery <34 weeks (65.2% vs 26.4%, RR 2.5, 95% CI 1.7-3.6) preterm delivery <28 weeks (34.8% vs 4.0%, RR 8.8, 95% CI 3.7-20.5) and admission to intensive care (68.2% vs 23.3%, RR 2.9, 95% CI 2.0-4.3). CONCLUSIONS: In appropriately grown twins, growth discordance is a risk factor for adverse perinatal outcomes in monochorionic, but not dichorionic, twins. Discordant monochorionic twins may benefit from increased antenatal surveillance. |
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Authors:
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Lorie M Harper; Matthew A Weis; Anthony O Odibo; Kimberly A Roehl; George A Macones; Alison G Cahill |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-28 |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: - ISSN: 1097-6868 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-2-1 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2013 Mosby, Inc. All rights reserved. |
Affiliation:
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The University of Alabama at Birmingham, Department of Obstetrics and Gynecology. Electronic address: lmharper@uabmc.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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