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  • Title: Neonatal outcome of preterm discordant twins.
    Author: Haimovich Y, Ascher-Landsberg J, Azem F, Mandel D, Mimouni FB, Many A.
    Journal: J Perinat Med; 2011 May; 39(3):317-22. PubMed ID: 21488810.
    Abstract:
    OBJECTIVE: To estimate the influence of fetal growth restriction (FGR) on neonatal morbidity and mortality among premature discordant twin neonates. STUDY DESIGN: Our medical records (2002-2007) of preterm twins born at 24-37 weeks' gestation were reviewed. Significant discordance was defined as >15% difference in birth weight. Small for gestational age (SGA) was defined as birth weight <10(th) percentile, and appropriate for gestational age (AGA) was between the 10(th) and 90(th) percentile, according to a twin and sex-adjusted gestational age nomogram. The SGA/AGA group comprised of one SGA twin and its AGA pair (30 pairs). Another group of non-SGA discordant twins was also evaluated (n=40 pairs, AGA/AGA). The morbidity and mortality rates were compared between the groups. RESULTS: Of the selected outcome variables, the only ones in which the incidence was significantly lower for SGA neonates than their AGA pairs were respiratory distress syndrome (5 vs. 11, P=0.014), apnea (1 vs. 9, P=0.004) and the need for respiratory support (5 vs. 14, P=0.002). Anemia, erythropoietin therapy and hyperbilirubinemia were significantly higher in the SGA twin. All selected outcome variables had similar rates within the AGA/AGA pairs. CONCLUSION: FGR among premature discordant twin pairs is associated with significantly lower rates of respiratory morbidity and higher anemia and erythropoietin therapy rates. Overall morbidity is similar for discordant non-FGR twin pairs.
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