OBJECTIVE: We sought to determine whether twin gestations with an anomalous fetus are at increased risk of preterm delivery or intrauterine growth restriction (IUGR) compared to twins with 2 normal fetuses. STUDY DESIGN: This was a retrospective cohort of twins undergoing ultrasound 15-22 weeks' gestation. Groups were defined by the presence of 1 twin with a major anomaly (discordant) or by twins with no major anomalies (normal). The primary outcomes were preterm delivery (<37 weeks) and IUGR (<10th percentile). RESULTS: Of 1977 twin pregnancies, 66 had a twin with a major anomaly. Preterm delivery occurred in 42 (63.6%) discordant twins, compared to 1271 (66.5%) normal twins (risk ratio, 1.0; 95% confidence interval, 0.8-1.2). IUGR was diagnosed in 15 (22.7%) normal co-twins, compared to 406 (21.3%) presenting twins in normal twins (risk ratio, 1.1; 95% confidence interval, 0.7-1.7). CONCLUSION: Twins discordant for major anomalies are not at increased risk of preterm delivery or IUGR compared to twins with no major anomalies.
OBJECTIVE: We sought to determine whether twin gestations with an anomalous fetus are at increased risk of preterm delivery or intrauterine growth restriction (IUGR) compared to twins with 2 normal fetuses. STUDY DESIGN: This was a retrospective cohort of twins undergoing ultrasound 15-22 weeks' gestation. Groups were defined by the presence of 1 twin with a major anomaly (discordant) or by twins with no major anomalies (normal). The primary outcomes were preterm delivery (<37 weeks) and IUGR (<10th percentile). RESULTS: Of 1977 twin pregnancies, 66 had a twin with a major anomaly. Preterm delivery occurred in 42 (63.6%) discordant twins, compared to 1271 (66.5%) normal twins (risk ratio, 1.0; 95% confidence interval, 0.8-1.2). IUGR was diagnosed in 15 (22.7%) normal co-twins, compared to 406 (21.3%) presenting twins in normal twins (risk ratio, 1.1; 95% confidence interval, 0.7-1.7). CONCLUSION: Twins discordant for major anomalies are not at increased risk of preterm delivery or IUGR compared to twins with no major anomalies.
Authors: Stephanie E Purisch; Emily A DeFranco; Louis J Muglia; Anthony O Odibo; David M Stamilio Journal: Am J Obstet Gynecol Date: 2008-09 Impact factor: 8.661