Urszula Nowacka1,2, Katarzyna Kosińska-Kaczyńska3, Paweł Krajewski1, Aleksandra Saletra-Bielińska1, Izabela Walasik4, Iwona Szymusik1. 1. Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicza Square 1/3, 02-015 Warsaw, Poland. 2. Department of Obstetrics and Gynecology, Institute of Mother and Child, Kasprzaka 17a, 01-211 Warsaw, Poland. 3. Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Cegłowska St. 80, 01-809 Warsaw, Poland. 4. Students Scientific Association, Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicza Square 1/3, 02-015 Warsaw, Poland.
Abstract
BACKGROUND: Fetal growth of twins differs from singletons. The objective was to assess the fetal growth in twin gestations in relation to singleton charts and customized twin charts, respectively, followed by a comparison of the frequency of neonatal complications in small-for-gestational-age (SGA) twins. METHODS: We performed an analysis of twin pregnancies with established chorionicity with particular emphasis on postnatal adverse outcomes in newborns classified as SGA. Neonatal birth weight was comparatively assessed using both singleton and twin growth charts with following percentile estimation. Using a statistical model, we established the prediction strength of neonatal complications in SGA twins for both methods. RESULTS: The dataset included 322 twin pairs (247 cases of dichorionic and 75 cases of monochorionic diamniotic gestations). Utilization of twin-specific normograms was less likely to label twins as SGA-nevertheless, this diagnosis strongly correlated with risk of observing adverse outcomes. Using a chart dedicated for twin pregnancies predicted newborn complications in the SGA group with higher sensitivity and had better positive predictive value regarding postnatal morbidity. CONCLUSIONS: Estimating twin growth with customized charts provides better prognosis of undesirable neonatal events in the SGA group comparing to singleton nomograms and consequently might determine neonatal intensive care prenatal approach.
BACKGROUND: Fetal growth of twins differs from singletons. The objective was to assess the fetal growth in twin gestations in relation to singleton charts and customized twin charts, respectively, followed by a comparison of the frequency of neonatal complications in small-for-gestational-age (SGA) twins. METHODS: We performed an analysis of twin pregnancies with established chorionicity with particular emphasis on postnatal adverse outcomes in newborns classified as SGA. Neonatal birth weight was comparatively assessed using both singleton and twin growth charts with following percentile estimation. Using a statistical model, we established the prediction strength of neonatal complications in SGA twins for both methods. RESULTS: The dataset included 322 twin pairs (247 cases of dichorionic and 75 cases of monochorionic diamniotic gestations). Utilization of twin-specific normograms was less likely to label twins as SGA-nevertheless, this diagnosis strongly correlated with risk of observing adverse outcomes. Using a chart dedicated for twin pregnancies predicted newborn complications in the SGA group with higher sensitivity and had better positive predictive value regarding postnatal morbidity. CONCLUSIONS: Estimating twin growth with customized charts provides better prognosis of undesirable neonatal events in the SGA group comparing to singleton nomograms and consequently might determine neonatal intensive care prenatal approach.
Entities:
Keywords:
fetal growth; fetal growth restriction; growth chart; small for gestational age; twin gestation
Authors: Marij Gielen; Patrick J Lindsey; Catherine Derom; Ruth J F Loos; Nicole Y Souren; Aimee D C Paulussen; Maurice P Zeegers; Robert Derom; Robert Vlietinck; Jan G Nijhuis Journal: Twin Res Hum Genet Date: 2008-04 Impact factor: 1.587
Authors: M Baraa Allaf; Winston A Campbell; Anthony M Vintzileos; Sina Haeri; Pouya Javadian; Amir A Shamshirsaz; Paul Ogburn; Reinaldo Figueroa; Joseph Wax; Glenn Markenson; Martin R Chavez; Samadh F Ravangard; Rodrigo Ruano; Haleh Sangi-Haghpeykar; Bahram Salmanian; Marjorie Meyer; Jeffery Johnson; Ali Ozhand; Sarah Davis; Adam Borgida; Michael A Belfort; Alireza A Shamshirsaz Journal: J Ultrasound Med Date: 2014-09 Impact factor: 2.153
Authors: Katja Bricelj; Isaac Blickstein; Gabrijela Bržan-Šimenc; Vid Janša; Miha Lučovnik; Ivan Verdenik; Andreja Trojner-Bregar; Nataša Tul Journal: J Matern Fetal Neonatal Med Date: 2016-06-13
Authors: Mia Kibel; Michael Kahn; Christopher Sherman; John Kingdom; Arthur Zaltz; Jon Barrett; Nir Melamed Journal: Placenta Date: 2017-10-13 Impact factor: 3.481
Authors: Katherine L Grantz; Jagteshwar Grewal; Paul S Albert; Ronald Wapner; Mary E D'Alton; Anthony Sciscione; William A Grobman; Deborah A Wing; John Owen; Roger B Newman; Edward K Chien; Robert E Gore-Langton; Sungduk Kim; Cuilin Zhang; Germaine M Buck Louis; Mary L Hediger Journal: Am J Obstet Gynecol Date: 2016-04-30 Impact factor: 8.661