Effect of morphological and functional changes in the secundines on biometric parameters of newborns from dichorionic twin pregnancies

Abstract

Objectives: The aim of the study was to determine if, and to what extent, structural and functional changes of the secundines influence biometric parameters of neonates from dichorionic twin pregnancies. Material and methods:The study included neonates from dichorionic, diamniotic twin pregnancies, along with their secundines. Based on histopathological examination of the secundines, the mass and dimensions of the placenta, length and condition of the umbilical cord, chorionicity, focal lesions, and microscopic placental abnormalities were determined for 445 pairs of twins. Morphological development of examined twins was characterized on the basis of their six somatic traits, while birth status of the newborns was assessed based on their Apgar scores. Statistical analysis included Student t-tests, Snedecor's F-tests, post-hoc tests, non-parametric chi-squared Pearson's tests, and determination of Spearman coefficients of rank correlation. Results:The lowest values of analyzed somatic traits were observed in twins who had placentas with velamentous or marginal cord insertion. Inflammatory lesions in the placenta and placental abruption turned out to have the greatest impact of all analyzed abnormalities of the secundines. Inflammatory lesions in the placenta were associated with lower values of biometric parameters and a greater likelihood of preterm birth. Neonates with a history of placental abruption were characterized by significantly lower birth weight and smaller chest circumference. Conclusions:Morphological changes in the secundines have a limited impact on biometric parameters of neonates from dichorionic twin pregnancies. In turn, functional changes exert a significant effect and more often contribute to impaired fetal development.

Velamentous cord insertion: results from a rapid review of incidence, risk factors, adverse outcomes and screening

“…Incidence was reported to be higher in twin pregnancies (Fig. 2), ranging from 1.6 to 40% per pregnancy (affecting at least one fetus) [42,43]. The reported incidence of VCI per fetus in twin pregnancies ranged from 3.5 to 20.7% [42,[44][45][46][47][48].…”

“…Seven studies assessed the association between VCI and low neonatal Apgar scores: 5 in singletons, one in unselected pregnancies and one in DC twins [4,5,7,9,43,57,62]. Apgar scores at both 1 and 5 min were evaluated in all but one study, which included 5-min scores only [4].…”

“…Definitions of "low" Apgar scores varied across studies (< 7 or ≤ 7), and while most studies evaluated the low Apgar score risk with OR, one case-control study compared mean and standard deviation (SD) of 1-min and 5-min Apgar scores between VCI and non-VCI pregnancies, finding both to be significantly lower in neonates from VCI pregnancies [9]. Another study only reported mean and SD of Apgar scores originating from DC twin pregnancies complicated by VCI [43]. Additionally, among the other studies that found low Apgar scores to be more common in VCI cases [4,5,57], one may have included multiple pregnancies [57].…”

Children's daily lives and well‐being: Findings from the CORONA‐CODOMO survey 1st wave

“…It was lifted in stages, region by region, starting on May 14, 2020, and nationwide on May 25, 2020. Thus, 80% of primary and secondary schools remained closed until mid‐May 2020 5,6 …”