TY - JOUR
T1 - Short and long term perinatal outcome in twin pregnancies affected by weight discordance
AU - Vedel, Cathrine
AU - Oldenburg, Anna
AU - Worda, Katharina
AU - Larsen, Helle
AU - Holmskov, Anni
AU - Andreasen, Kirsten Riis
AU - Uldbjerg, Niels
AU - Ramb, Jan
AU - Bødker, Birgit
AU - Skibsted, Lillian
AU - Sperling, Lene
AU - Hinterberger, Stefan
AU - Krebs, Lone
AU - Zingenberg, Helle
AU - Weiss, Eva-Christine
AU - Strobl, Isolde
AU - Laursen, Lone
AU - Christensen, Jeanette Tranberg
AU - Ersbak, Vibeke
AU - Stornes, Inger
AU - Krampl-Bettelheim, Elisabeth
AU - Tabor, Ann
AU - Rode, Line
N1 - This article is protected by copyright. All rights reserved.
PY - 2017
Y1 - 2017
N2 - OBJECTIVE: To investigate the association between chorionicity-specific intertwin birthweight (BW) discordance and adverse outcomes including long-term follow-up at 6, 18, and 48-60 months after term via Ages and Stages Questionnaire (ASQ).MATERIAL AND METHODS: In this secondary analysis of a cohort study (Oldenburg et al,n=1688) and a randomized controlled trial (PREDICT study,n=1045) twin pairs were divided into three groups according to chorionicity-specific BW discordance; <75(th) -percentile, 75(th) -90(th) -percentile and >90(th) -percentile. Information on infant mortality, admittance to NICU, and gestational age at delivery was available for all pairs. Detailed neonatal outcomes were available for 656 pairs from PREDICT, of which 567 pairs had at least one ASQ follow-up. Logistic regression models were used for dichotomous outcomes. ASQ scores were compared using the method of generalized estimating equation to account for the correlation within twins.RESULTS: The 75(th) and 90(th) -percentile for BW discordance were 14.8% and 21.4% for monochorionic and 16.0% and 23.8% for dichorionic twins. After adjustment for small for gestational age (SGA) and gender, BW discordance>75(th) and >90(th) -percentile was associated with induced delivery<34 weeks (OR 1.71 (95%CI 1.11;2.65) and OR 2.83 (1.73;4.64), respectively). Discordance>75(th) -percentile was associated with an increased risk of infant mortality after 28 days (OR 4.69 (1.07;20.45)) but not with major neonatal complications or with low mean ASQ scores at 6, 18, and 48-60 months after term.CONCLUSION: Chorionicity-specific intertwin BW discordance is a risk factor for induced preterm delivery and infant mortality, but not for lower scores for neurophysiological development at 6, 18, and 48-60 months. This article is protected by copyright. All rights reserved.
AB - OBJECTIVE: To investigate the association between chorionicity-specific intertwin birthweight (BW) discordance and adverse outcomes including long-term follow-up at 6, 18, and 48-60 months after term via Ages and Stages Questionnaire (ASQ).MATERIAL AND METHODS: In this secondary analysis of a cohort study (Oldenburg et al,n=1688) and a randomized controlled trial (PREDICT study,n=1045) twin pairs were divided into three groups according to chorionicity-specific BW discordance; <75(th) -percentile, 75(th) -90(th) -percentile and >90(th) -percentile. Information on infant mortality, admittance to NICU, and gestational age at delivery was available for all pairs. Detailed neonatal outcomes were available for 656 pairs from PREDICT, of which 567 pairs had at least one ASQ follow-up. Logistic regression models were used for dichotomous outcomes. ASQ scores were compared using the method of generalized estimating equation to account for the correlation within twins.RESULTS: The 75(th) and 90(th) -percentile for BW discordance were 14.8% and 21.4% for monochorionic and 16.0% and 23.8% for dichorionic twins. After adjustment for small for gestational age (SGA) and gender, BW discordance>75(th) and >90(th) -percentile was associated with induced delivery<34 weeks (OR 1.71 (95%CI 1.11;2.65) and OR 2.83 (1.73;4.64), respectively). Discordance>75(th) -percentile was associated with an increased risk of infant mortality after 28 days (OR 4.69 (1.07;20.45)) but not with major neonatal complications or with low mean ASQ scores at 6, 18, and 48-60 months after term.CONCLUSION: Chorionicity-specific intertwin BW discordance is a risk factor for induced preterm delivery and infant mortality, but not for lower scores for neurophysiological development at 6, 18, and 48-60 months. This article is protected by copyright. All rights reserved.
U2 - 10.1111/aogs.13062
DO - 10.1111/aogs.13062
M3 - Journal article
C2 - 27861703
SN - 0001-6349
VL - 96
SP - 233
EP - 242
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
IS - 2
ER -