OBJECTIVE: To examine the effects of the chorionicity of the placenta on infant outcome at 1 year of age in twin pregnancies. STUDY DESIGN: Cohort study and retrospective review of the medical records of 44 monochorionic (MC) and 164 dichorionic (DC) twin gestations that had been followed at our institution since < 20 weeks' gestation. Physical and neurologic status was assessed at 1 year of corrected age in infants born to these 208 women. RESULTS: Adverse infant outcomes, such as death, cerebral palsy and mental retardation, occurred in 9 (10%) of 88 MC infants (4 deaths and 5 disabled infants) as compared with 12 (3.7%) of 328 DC infants (6 deaths and 6 disabled infants) (P < .05). Although delivery occurred one week earlier in MC than in DC twins (34.7 +/- 2.8 vs. 35.7 +/- 2.3 weeks, P < .01), there was no significant difference in gestational age at birth or birth weight between the 9 MC and 12 DC infants with adverse outcomes. A presumptive antenatal diagnosis of twin-twin transfusion syndrome (TTTS) was made in 14 (32%) of the 44 MC twin gestations. TTTS was considered to be responsible for adverse outcome in 7 MC infants. All 9 MC infants with adverse outcomes and 4 (33%) of 12 DC infants with adverse outcomes belonged to pairs that had weight discordance > or = 25% (P < .01). CONCLUSION: MC twins had an increased risk of adverse outcomes as compared with DC twins, mainly because of TTTS. In both MC and DC twins, a birth weight discordance > or = 25% was associated with adverse infant outcomes. The number of infants with disabilities at 1 year of age was equal to the number of deaths.
OBJECTIVE: To examine the effects of the chorionicity of the placenta on infant outcome at 1 year of age in twin pregnancies. STUDY DESIGN: Cohort study and retrospective review of the medical records of 44 monochorionic (MC) and 164 dichorionic (DC) twin gestations that had been followed at our institution since < 20 weeks' gestation. Physical and neurologic status was assessed at 1 year of corrected age in infants born to these 208 women. RESULTS: Adverse infant outcomes, such as death, cerebral palsy and mental retardation, occurred in 9 (10%) of 88 MCinfants (4 deaths and 5 disabled infants) as compared with 12 (3.7%) of 328 DC infants (6 deaths and 6 disabled infants) (P < .05). Although delivery occurred one week earlier in MC than in DC twins (34.7 +/- 2.8 vs. 35.7 +/- 2.3 weeks, P < .01), there was no significant difference in gestational age at birth or birth weight between the 9 MC and 12 DC infants with adverse outcomes. A presumptive antenatal diagnosis of twin-twin transfusion syndrome (TTTS) was made in 14 (32%) of the 44 MC twin gestations. TTTS was considered to be responsible for adverse outcome in 7 MCinfants. All 9 MCinfants with adverse outcomes and 4 (33%) of 12 DC infants with adverse outcomes belonged to pairs that had weight discordance > or = 25% (P < .01). CONCLUSION:MC twins had an increased risk of adverse outcomes as compared with DC twins, mainly because of TTTS. In both MC and DC twins, a birth weight discordance > or = 25% was associated with adverse infant outcomes. The number of infants with disabilities at 1 year of age was equal to the number of deaths.
Authors: Olivia Barigye; Lucia Pasquini; Paula Galea; Helen Chambers; Lucy Chappell; Nicholas M Fisk Journal: PLoS Med Date: 2005-06-28 Impact factor: 11.069
Authors: Marjolijn S Spruijt; Enrico Lopriore; Ratna N G B Tan; Femke Slaghekke; Frans J C M Klumper; Johanna M Middeldorp; Monique C Haak; Dick Oepkes; Monique Rijken; Jeanine M M van Klink Journal: J Clin Med Date: 2019-08-15 Impact factor: 4.241
Authors: Karien E A Hack; Corine Koopman-Esseboom; Jan B Derks; Sjoerd G Elias; Martin J K de Kleine; Wim Baerts; Attie T J I Go; Arty H P Schaap; Mark A H B M van der Hoeven; Alex J Eggink; Krystyna M Sollie; Nynke Weisglas-Kuperus; Gerard H A Visser Journal: PLoS One Date: 2009-08-28 Impact factor: 3.240