title: Intertwin crown-rump length discordance in the prediction of fetal anomalies, fetal loss and adverse perinatal outcome.
abstract: OBJECTIVE
  To assess the risks of fetal anomalies, fetal loss and adverse perinatal outcome in a cohort of first-trimester intertwin crown-rump length (CRL) discordant twins, stratified by chorionicity and the degree of CRL discordance.
  
  
  METHODS
  Four-hundred-and-seventy-one twin pregnancies were scanned during an 8-year period at 11-14 weeks, and those with an intertwin CRL discordance ≥10% were compared with concordant twins. Outcomes were also compared between monochorionic and dichorionic twins and between moderate (10-16%) and severe (>16%) discordance.
  
  
  RESULTS
  Four-hundred-and-five twin pregnancies, 65 discordant and 340 concordant, were follow-up. Discordant twin pregnancies were at significant higher risk of chromosomal (OR = 11.42; 95% CI: 2.78-46.94) and structural anomalies (OR = 5.91; 95% CI: 2.25-15.54), spontaneous fetal loss (OR = 4.23; 95% CI: 1.79-10.01), birthweight discordance (OR = 2.8; 95% CI: 1.48-5.65) and small-for-gestational age (OR = 3.48; 95% CI: 1.78-6.79). Similar differences (except for birthweight discordance) were observed among dichorionic twins. Among monochorionic, increased frequencies were only seen for structural anomalies, birthweight discordance and small newborns. Severe CRL discordance presented with higher rates of structural anomalies, stillbirth, birthweight discordance and small newborns.
  
  
  CONCLUSIONS
  Intertwin CRL discordance (≥10%) results in an increased risk of fetal anomalies and growth restriction that increases in severe CRL discordance (≥16%).
authors.affiliation: a Department of Maternal-Fetal Medicine , Institute Gynecology, Obstetrics and Neonatology, Hospital Clinic Barcelona , Catalonia , Spain and.|b CIBER De Enfermedades Raras, Instituto De Salud Carlos III , Madrid , Spain.
authors.forename: Maribel
authors.initials: M
authors.lastname: Grande
authors.affiliation: a Department of Maternal-Fetal Medicine , Institute Gynecology, Obstetrics and Neonatology, Hospital Clinic Barcelona , Catalonia , Spain and.
authors.forename: Anna
authors.initials: A
authors.lastname: Goncé
authors.affiliation: a Department of Maternal-Fetal Medicine , Institute Gynecology, Obstetrics and Neonatology, Hospital Clinic Barcelona , Catalonia , Spain and.
authors.forename: Iosifina
authors.initials: I
authors.lastname: Stergiotou
authors.affiliation: a Department of Maternal-Fetal Medicine , Institute Gynecology, Obstetrics and Neonatology, Hospital Clinic Barcelona , Catalonia , Spain and.
authors.forename: Mar
authors.initials: M
authors.lastname: Bennasar
authors.affiliation: a Department of Maternal-Fetal Medicine , Institute Gynecology, Obstetrics and Neonatology, Hospital Clinic Barcelona , Catalonia , Spain and.|b CIBER De Enfermedades Raras, Instituto De Salud Carlos III , Madrid , Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Borrell
mesh_terms: D000013:Congenital Abnormalities; D018568:Crown-Rump Length; D005260:Female; D005313:Fetal Death; D047109:Fetal Development; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D059285:Pregnancy, Twin; D016216:Ultrasonography, Prenatal
keywords: Adverse perinatal outcome; CRL discordance; fetal anomalies; fetal loss