title: Fetal phenotypes and neonatal and early childhood outcomes in twins.
abstract: OBJECTIVE
  The purpose of this study was to evaluate factors associated with, and postnatal consequences of, altered patterns of fetal growth in twins.
  
  
  METHODS
  Fetal growth was measured at 28 weeks' gestation on 218 twins, including head circumference, abdominal circumference, and femur length, and characterized as > or < or =10th %ile; children were followed up until the age of three years. Logistic regression was used to generate odds ratios of perinatal factors associated with reduced fetal growth.
  
  
  RESULTS
  Maternal height <62 inches was associated with reductions in femur length (adjusted odds ratio [AOR] 3.88, 95% CI 1.42-10.57) and abdominal circumference (AOR 8.63, 95% CI 2.41-30.94), while primiparity had a protective effect on both of these fetal measurements (AOR 0.28, 95% CI 0.13-0.64, and AOR 0.18, 95% CI 0.06-0.60, respectively), as well as head circumference (AOR 0.32, 95% CI 0.15-0.69). Smoking adversely affected femur and head growth (AOR 24.10, 95% CI 3.69-157.57, and AOR 10.82, 95% CI 1.73-67.79, respectively). Fetal reduction adversely affected femur and abdomen growth (AOR 5.85, 95% CI 1.52-22.51 and AOR 4.90, 95% CI 1.01-23.86, respectively), and monochorionicity and maternal weight gain <0.65 lb/wk before 20 weeks adversely affected femur growth (AOR 5.47, 95% CI 1.65-18.10, and AOR 3.39, 95% CI 1.34-8.59, respectively). At age 3 years, all categories of twins with reduced growth by 28 weeks' gestation were significantly shorter in height, and those with reduced abdominal circumference or head circumference at 28 weeks were also significantly lighter in weight compared with twins with adequate fetal growth by 28 weeks' gestation.
  
  
  CONCLUSIONS
  These data identify short maternal height, smoking, monochorionicity, fetal reduction, and inadequate weight gain before 20 weeks as risk factors associated with reduced twin fetal growth by 28 weeks' gestation and significant residual reductions in height and weight through 3 years of age.
authors.affiliation: Department of Epidemiology and Public Health, University of Miami School of Medicine, Miami, FL, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Luke
authors.forename: Morton B
authors.initials: MB
authors.lastname: Brown
authors.forename: Mary L
authors.initials: ML
authors.lastname: Hediger
authors.forename: Clark
authors.initials: C
authors.lastname: Nugent
authors.forename: Ruta B
authors.initials: RB
authors.lastname: Misiunas
authors.forename: Elaine
authors.initials: E
authors.lastname: Anderson
mesh_terms: D001827:Body Height; D001835:Body Weight; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005269:Femur / Q000196:embryology; D047109:Fetal Development / Q000502:physiology; D005333:Fetus / Q000187:drug effects; D006257:Head / Q000196:embryology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange / Q000187:drug effects; D010641:Phenotype; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014427:Twins / Q000502:physiology*