Cerebral injury in monochorionic twins with selective intrauterine growth restriction and/or birthweight discordance.
OBJECTIVE
The objective of the study was to study the incidence of severe cerebral injury in monochorionic (MC) twins with selective intrauterine growth restriction (sIUGR) and/or birthweight discordance.


METHODS
All MC twin pregnancies with 2 liveborn twins were included in the study. We excluded all cases with twin-to-twin transfusion syndrome (TTTS). Sequential cranial ultrasound scans were performed in all MC twin infants.


RESULTS
A total of 117 MC twin pairs were included in the study. The sIUGR of at least 1 fetus was found in 50 twin pregnancies (43%), and birthweight discordance of 25% or greater occurred in 26 twin pregnancies (22%). The overall incidence of severe cerebral injury was 3% (6/218). The incidence of severe cerebral injury in infants from twin pregnancies with and without sIUGR was 2% (2/94) and 3% (4/124), respectively (P = .62). The incidence of severe cerebral injury in infants with and without birthweight discordance was 0% (0/48) and 4% (6/170), respectively (P = .19).


CONCLUSIONS
The incidence of severe cerebral injury in MC twin pregnancies not complicated by TTTS with 2 liveborn twins is low. No association could be demonstrated with sIUGR or intertwin birthweight discordance of 25% or greater.
Lopriore
Enrico
E
Division of Neonatology, Department of Pediatrics, Leiden University Medical Centre, Leiden, The Netherlands.
Slaghekke
Femke
F
Vandenbussche
Frank P
FP
Middeldorp
Johanna M
JM
Walther
Frans J
FJ
Oepkes
Dick
D
D000328:Adult; D000704:Analysis of Variance; D001724:Birth Weight; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D014430:Twins, Monozygotic; D016216:Ultrasonography, Prenatal; D055815:Young Adult