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

Stuart Ward, Adedayo L Adegbite, Rekha Bajoria, Shirley Castille

Author affiliations (3)
  • McMaster University ROR
  • University of Manchester ROR
  • St Mary's Hospital ROR

American Journal of Obstetrics and Gynecology, 190(1), 156-163, 2004

DOI 10.1016/j.ajog.2003.07.004 PMID 14749653

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

Pregnancy > Multiple Gestation > Monochorionic Twin ComplicationsPregnancy > Prematurity > Neurodevelopmental OutcomesPregnancy > Multiple Gestation > Twin-Twin Transfusion Syndrome
monochorionic dichorionic twins neuromorbidity cerebral palsy preterm, twin-twin transfusion syndrome neurologic outcomes preterm infants, chorionicity discordant birth weight neurodevelopmental outcome, monochorionic twins cerebral palsy risk cotwin death, preterm twin neurodevelopment discordant growth restriction, TTTS neurologic morbidity monochorionic twins incidence, dichorionic versus monochorionic twins neurologic disability, preterm twins 24-34 weeks neurodevelopmental follow-up, discordant birth weight cerebral palsy twin pregnancy, cotwin intrauterine death neurologic outcome surviving twin
PMID 14749653 14749653 DOI 10.1016/j.ajog.2003.07.004 10.1016/j.ajog.2003.07.004

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/epidemiology, Female, Fetal Death/complications, Fetofetal Transfusion/complications, Humans, Incidence, Infant, Newborn, Infant, Premature, Male, Nervous System Diseases/epidemiology/etiology, Pregnancy, Twins, Dizygotic/statistics & Numerical Data, Twins, Monozygotic/statistics & Numerical Data

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