title: Cerebral injury in monochorionic twins with selective intrauterine growth restriction and/or birthweight discordance.
abstract: 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.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Enrico
authors.initials: E
authors.lastname: Lopriore
authors.forename: Femke
authors.initials: F
authors.lastname: Slaghekke
authors.forename: Frank P
authors.initials: FP
authors.lastname: Vandenbussche
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Middeldorp
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Walther
authors.forename: Dick
authors.initials: D
authors.lastname: Oepkes
mesh_terms: 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