Birth weight discordance of twin pairs and their subsequent growth patterns

Objective Research suggests that postnatal catch-up growth after fetal growth restriction (FGR) occurs frequently. Yet, postnatal growth in singletons may be influenced by multiple factors. Identical twins with discordant prenatal growth, termed selective FGR (sFGR), can be regarded as a natural experiment eliminating these sources of bias. Design Observational cohort study. Methods Monochorionic twins with sFGR born between 2002-2017 (aged 3-17 years) were eligible. Growth measurements (height, weight, head circumference, body mass index) were performed at follow-up. Detailed growth curves documented by a systematic primary care system in the Netherlands were collected. Measurements were converted to standard deviation scores (SDS). A mixed-effects model was used to assess within-pair SDS difference and individual height SDS relative to target height SDS. Results Forty-seven twin pairs (94 children) were included at a median age of 11 (interquartile range 8-13) years. At the last measurement, smaller twins at birth had a lower height SDS (-0.6 vs. -0.3, p<0.001, median difference 0.5 (95%CI 0.4-0.7)), lower weight SDS (-0.5 vs. -0.1, p<0.001, median difference 0.8 (95%CI 0.5-1.0)) and lower head circumference SDS (-0.5 vs 0.2, p<0.001, median difference 0.8 (95%CI 0.6-0.9)) compared to larger twins. These differences persisted until the age of seventeen. Smaller twins showed rapid catch-up growth in the first two years and reached their target height range between 8-11 years. Conclusions Identical twins with discordant prenatal growth maintain a modest but significant difference in height, weight and head circumference, indicating a persistent, inhibitory effect of an adverse intrauterine environment on childhood growth.

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The Discordance of Intra-twin Birth Weight by Infantile Gender and Birth Order in Korea; 2008-2013

Park

Shin

Kim

et al. 2015

Korean J Perinatol

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Purpose:To investigate the incidence of intra-twin birth weight discordance and its association with infantile gender and birth order. Methods: We used the data of birth from 2008 to 2013 of Korea Statistics (38,140 pairs of twins). Adjusted logistic regression analyses were performed to describe the birth weight discordance (≥25%) according to in fantile gender and birth order (twin A: 1st, twin B: 2nd). Birth weight discordance was calculated as 100 x (birth weight difference/birth weight of the heavier twin). Results: Twin A (mean 2.431 kg) was heavier than twin B (mean 2.359 kg), and the weight difference was 0.281 kg on average. Overall incidence of birth weight discordance was 8.3 percent. The incidence of discordance was 8.8 percent among unlike-sexed pairs and 8.0 percent among like-sexed pairs. Twins with birth weight A≥B (10.2 percent) showed higher incidence of discordance than twins with birth weight A

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Birth weight discordance of twin pairs and their subsequent growth patterns

Cited by 6 publications

References 16 publications

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The Discordance of Intra-twin Birth Weight by Infantile Gender and Birth Order in Korea; 2008-2013

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