OBJECTIVE: The purpose of this study was to evaluate the impact of noncentral placental cord insertion on birthweight discordance in twins. STUDY DESIGN: We performed a multicenter, prospective trial of twin pregnancies. Placental cord insertion was documented as central, marginal, or velamentous according to a defined protocol. Association of the placental cord insertion site with chorionicity, birthweight discordance, and growth restriction were assessed. RESULTS: Eight hundred sixteen twin pairs were evaluated; 165 pairs were monochorionic, and 651 pairs were dichorionic. Monochorionic twins had higher rates of marginal (P = .0068) and velamentous (P < .0001) placental cord insertion. Noncentral placental cord insertion was more frequent in smaller twins of discordant pairs than control pairs (29.8% vs 19.1%; P = .004). Velamentous placental cord insertion in monochorionic twins was associated significantly with birthweight discordance (odds ratio, 3.5; 95% confidence interval, 1.3-9.4) and growth restriction (odds ratio, 4; 95% confidence interval, 1.1-14.3). CONCLUSION: Noncentral placental cord insertion contributes to birthweight discordance in monochorionic twin pregnancies. Sonographic delineation of placental cord insertion may be of value in antenatal assessment of twin pregnancies.
OBJECTIVE: The purpose of this study was to evaluate the impact of noncentral placental cord insertion on birthweight discordance in twins. STUDY DESIGN: We performed a multicenter, prospective trial of twin pregnancies. Placental cord insertion was documented as central, marginal, or velamentous according to a defined protocol. Association of the placental cord insertion site with chorionicity, birthweight discordance, and growth restriction were assessed. RESULTS: Eight hundred sixteen twin pairs were evaluated; 165 pairs were monochorionic, and 651 pairs were dichorionic. Monochorionic twins had higher rates of marginal (P = .0068) and velamentous (P < .0001) placental cord insertion. Noncentral placental cord insertion was more frequent in smaller twins of discordant pairs than control pairs (29.8% vs 19.1%; P = .004). Velamentous placental cord insertion in monochorionic twins was associated significantly with birthweight discordance (odds ratio, 3.5; 95% confidence interval, 1.3-9.4) and growth restriction (odds ratio, 4; 95% confidence interval, 1.1-14.3). CONCLUSION: Noncentral placental cord insertion contributes to birthweight discordance in monochorionic twin pregnancies. Sonographic delineation of placental cord insertion may be of value in antenatal assessment of twin pregnancies.
Authors: Alexa A Freedman; Carol J Hogue; Carmen J Marsit; Augustine Rajakumar; Alicia K Smith; Katherine L Grantz; Robert L Goldenberg; Donald J Dudley; George R Saade; Robert M Silver; Karen J Gibbins; Radek Bukowski; Carolyn Drews-Botsch Journal: Am J Epidemiol Date: 2019-03-01 Impact factor: 4.897
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Authors: Yoshie Yokoyama; Aline Jelenkovic; Reijo Sund; Joohon Sung; John L Hopper; Syuichi Ooki; Kauko Heikkilä; Sari Aaltonen; Adam D Tarnoki; David L Tarnoki; Gonneke Willemsen; Meike Bartels; Toos C E M van Beijsterveldt; Kimberly J Saudino; Tessa L Cutler; Tracy L Nelson; Keith E Whitfield; Jane Wardle; Clare H Llewellyn; Abigail Fisher; Mingguang He; Xiaohu Ding; Morten Bjerregaard-Andersen; Henning Beck-Nielsen; Morten Sodemann; Yun-Mi Song; Sarah Yang; Kayoung Lee; Hoe-Uk Jeong; Ariel Knafo-Noam; David Mankuta; Lior Abramson; S Alexandra Burt; Kelly L Klump; Juan R Ordoñana; Juan F Sánchez-Romera; Lucia Colodro-Conde; Jennifer R Harris; Ingunn Brandt; Thomas Sevenius Nilsen; Jeffrey M Craig; Richard Saffery; Fuling Ji; Feng Ning; Zengchang Pang; Lise Dubois; Michel Boivin; Mara Brendgen; Ginette Dionne; Frank Vitaro; Nicholas G Martin; Sarah E Medland; Grant W Montgomery; Patrik K E Magnusson; Nancy L Pedersen; Anna K Dahl Aslan; Per Tynelius; Claire M A Haworth; Robert Plomin; Esther Rebato; Richard J Rose; Jack H Goldberg; Finn Rasmussen; Yoon-Mi Hur; Thorkild I A Sørensen; Dorret I Boomsma; Jaakko Kaprio; Karri Silventoinen Journal: Twin Res Hum Genet Date: 2016-04 Impact factor: 1.587
Authors: F Padula; A S Laganà; S G Vitale; L Mangiafico; L D'Emidio; P Cignini; M Giorlandino; F A Gulino; S Capriglione; C Giorlandino Journal: Facts Views Vis Obgyn Date: 2016-03-28