Hector Mendez-Figueroa1, Van Thi Thanh Truong2, Claudia Pedroza2, Suneet P Chauhan3. 1. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas. 2. Department of Pediatrics, Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas. 3. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas.
Abstract
OBJECTIVE: We hypothesized that utilization of a twin-specific nomograms, when compared with one based on singleton data, is less likely to classify twins as having abnormal growth and more likely to identify perinatal morbidity and mortality. MATERIALS AND METHODS: Data were culled from seven Maternal-Fetal Medicine Units (MFMU) studies, the included twin gestations in their study population. Each newborn twin's birth weight percentile was categorized using Alexander et al (singleton data) and Ananth et al (twin data) nomogram. Logistic regression models were adjusted for maternal race and body mass index, neonatal sex, study, and twin correlation. RESULTS: More twins were categorized as small for gestational age (SGA) when singleton nomogram was used (33%) compared with twin nomogram (4%). The use of singleton nomogram revealed a higher composite neonatal morbidity (CNM) and stillbirth rates among SGA twins but a similar neonatal mortality rate when compared with appropriate for gestational age. Correspondingly, when twin-specific nomogram was utilized, the CNM, odds of stillbirth, and neonatal mortality were higher among SGA twins. The rate of large for gestational age among twins was increased with the use of twin-specific nomograms. CONCLUSION: Utilization of twin-specific nomogram is less likely to categorize twins as SGA and more likely to identify those at risk for stillbirth and neonatal mortality. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: We hypothesized that utilization of a twin-specific nomograms, when compared with one based on singleton data, is less likely to classify twins as having abnormal growth and more likely to identify perinatal morbidity and mortality. MATERIALS AND METHODS: Data were culled from seven Maternal-Fetal Medicine Units (MFMU) studies, the included twin gestations in their study population. Each newborn twin's birth weight percentile was categorized using Alexander et al (singleton data) and Ananth et al (twin data) nomogram. Logistic regression models were adjusted for maternal race and body mass index, neonatal sex, study, and twin correlation. RESULTS: More twins were categorized as small for gestational age (SGA) when singleton nomogram was used (33%) compared with twin nomogram (4%). The use of singleton nomogram revealed a higher composite neonatal morbidity (CNM) and stillbirth rates among SGA twins but a similar neonatal mortality rate when compared with appropriate for gestational age. Correspondingly, when twin-specific nomogram was utilized, the CNM, odds of stillbirth, and neonatal mortality were higher among SGA twins. The rate of large for gestational age among twins was increased with the use of twin-specific nomograms. CONCLUSION: Utilization of twin-specific nomogram is less likely to categorize twins as SGA and more likely to identify those at risk for stillbirth and neonatal mortality. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Nir Melamed; Ahmet Baschat; Yoav Yinon; Apostolos Athanasiadis; Federico Mecacci; Francesc Figueras; Vincenzo Berghella; Amala Nazareth; Muna Tahlak; H David McIntyre; Fabrício Da Silva Costa; Anne B Kihara; Eran Hadar; Fionnuala McAuliffe; Mark Hanson; Ronald C Ma; Rachel Gooden; Eyal Sheiner; Anil Kapur; Hema Divakar; Diogo Ayres-de-Campos; Liran Hiersch; Liona C Poon; John Kingdom; Roberto Romero; Moshe Hod Journal: Int J Gynaecol Obstet Date: 2021-03 Impact factor: 3.561
Authors: Urszula Nowacka; Katarzyna Kosińska-Kaczyńska; Paweł Krajewski; Aleksandra Saletra-Bielińska; Izabela Walasik; Iwona Szymusik Journal: Int J Environ Res Public Health Date: 2021-02-19 Impact factor: 3.390