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Neuromorbidity in preterm twins in relation to chorionicity and discordant birth weight

Adegbite AL et al., 2004

American journal of obstetrics and gynecology, 190(1), 156-163

DOI 10.1016/j.ajog.2003.07.004 PMID 14749653 Source

Abstract

Objective

The purpose of this study was to determine the incidence of neurologic morbidity in preterm monochorionic (MC) and dichorionic (DC) twins.

Study design

We collected perinatal, neonatal, and infant follow-up data of 76 MC and 78 DC twins born between 24 and 34 weeks of gestation (295 infants). Risks of neuromorbidity in the surviving infants were evaluated in relation to chorionicity, discordant birth weight (>20%), twin-twin transfusion syndrome (TTTS), and cotwin death.

Results

The overall incidence of cerebral palsy and minor neurologic disabilities in surviving twins was 4% and 9%, respectively. MC infants had a higher incidence of cerebral palsy (8% vs 1%, P<.05) and neurologic morbidity (15% vs 3%, P<.05) than DC infants. The risk of impaired neurodevelopment was higher in MC infants with discordant birth weight (42%, P<.01), TTTS (37%, P<.01), and cotwin death (60%, P<.01) than those with concordant birth weight (8%). In MC pregnancies, the cerebral palsy risk was higher in infants with discordant birth weight than those with chronic TTTS (19% vs 4%, P<.05). Similarly, discordant DC infants had higher neuromorbidity than concordant group (5% vs 1%, P<.05). In both MC and DC discordant infants, neurologic morbidity was independent of growth restriction.

Conclusion

Neurologic morbidity in the preterm MC infants was 7-fold higher than DC infants because of chronic TTTS, discordant birth weight, and cotwin death in utero.

Topics

General OB/GYN > Other > Miscellaneous
preterm twins neurologic outcomes, monochorionic twin cerebral palsy, twin-twin transfusion syndrome neuromorbidity, discordant birth weight twins, dichorionic versus monochorionic twins, cotwin death neurologic disability, twin pregnancy brain injury risk, preterm monochorionic complications, birth weight discordance neurologic outcomes, twin chorionicity cerebral palsy risk

Cite this article

Adegbite, A. L., Castille, S., Ward, S., & Bajoria, R. (2004). Neuromorbidity in preterm twins in relation to chorionicity and discordant birth weight. *American journal of obstetrics and gynecology*, *190*(1), 156-163. https://doi.org/10.1016/j.ajog.2003.07.004

Keywords

Adult, Birth Weight, Diseases in Twins, Female, Fetal Death, Fetofetal Transfusion, Humans, Incidence, Infant, Newborn, Premature, Male, Nervous System Diseases, Pregnancy, Twins, Dizygotic, Monozygotic

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