Objectives:To compare the relationship between gestational age and inter twin birth weight discordance level. Methods: We used the 2007-2014 birth certificated data of Statistics Korea 51,783 pairs of twins. The data of unmatched twin cases, extra-marital birth and non-hospital birth cases were excluded. Birth weight discordance rate was calculated as (birth weight difference between larger and smaller birth weight/birth weight of heavier twin) x 100. Odds ratio and 95% confidence intervals were calculated from logistic regression analyses to describe the birth weight discordance ( ≥ 25%) of gestational age adjusted by year of birth, infantile gender, maternal age, maternal education, and age difference between couples. Results: The incidence of inter twin birth weight discordance was 55.3 percent in discordance of ≤ 9 percent, 10.9 percent in discordance of 20-29 percent, and 4.4 percent in discordance of ≥ 30 percent. The frequency of more than 25 percent discordant set demonstrated polynomial relationship to gestational age (Y = -82.294+6.226X-0.101X 2 , R 2 = 0.77, p < 0.01). Overall incidence of birth weight discordance more than 25 percent was 8.3 percent. The frequency of discordance level ( ≥ 25%) by gestational age was 10.7 percent in extremely preterm ( ≤ 27 weeks), 14.3 percent in very preterm (28-31 weeks), 13.1 percent in moderate preterm (32-33 weeks), 8.7 percent in late preterm (34-36 weeks), and 5.8 percent in full and late term ( ≥ 39 weeks). The rate of discordance level of ≥ 25 percent decreased with increasing gestational age. Compared with discordance level ( ≥ 25%) of full and late term, odds ratio of discordance level ( ≥ 25%) was 2.76 (95% confidence interval; 2.05-3.70) in very preterm, 2.48 (1.86-3.31) in moderate preterm, 1.97 (1.37-2.83) in extremely preterm, and 1.56 (1.19-2.05) in late preterm. Conclusions: The risk of discordance level of ≥ 25 percent increased significantly with very preterm and moderate preterm birth. There is a need to understand the contributing factors and close attention to reduce the risk of discordance level of ≥ 25 percent in gestational age from 28 to 33 weeks.
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