title: Perinatal outcomes in growth-restricted twins compared with age-matched growth-restricted singletons.
abstract: The objective of this study was to compare the perinatal outcomes in growth-restricted (IUGR) twins with a matched group of IUGR singletons. We performed a retrospective cohort study evaluating the perinatal outcomes in IUGR twins matched for gestational age at delivery to the next four IUGR singletons (1:4) in our perinatal database. The perinatal outcomes evaluated included rates of uncorrected perinatal mortality (PMR), admission to the neonatal intensive care unit (NICU), respiratory distress syndrome, grades 3 or 4 intraventricular hemorrhage, necrotizing enterocolitis, periventricular leukomalacia, and length of NICU stay. A cohort of twins with IUGR were matched with a cohort of IUGR singletons and compared for perinatal outcomes. A p value < 0.05 was considered significant. During the study period, we identified 99 IUGR twins meeting our inclusion criteria. These were matched with 396 singletons with IUGR. The mean gestational age at delivery for the twins was 34 +/- 3.8 weeks and 35 +/- 3.5 weeks for the singletons ( p = 0.11). The PMR in twins was significantly higher than in singletons (OR, 2.2; 95% confidence interval, 1.1 to 5.7). Perinatal morbidity was similarly significantly higher in IUGR twins. Compared with age-matched singletons, twins with IUGR have higher perinatal mortality and morbidity rates.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA.
authors.forename: Anthony O
authors.initials: AO
authors.lastname: Odibo
authors.forename: Raegan E
authors.initials: RE
authors.lastname: McDonald
authors.forename: David M
authors.initials: DM
authors.lastname: Stamilio
authors.forename: Serdar H
authors.initials: SH
authors.lastname: Ural
authors.forename: George A
authors.initials: GA
authors.lastname: Macones
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016208:Databases, Factual; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008297:Male; D008499:Medical Records; D010414:Pennsylvania / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D012189:Retrospective Studies; D014427:Twins