title: [Neurodevelopmental Outcomes of Very Preterm or Very Low Birth Weigth Infants: Comparison of Monochorionic and Dichorionic Twins with Singletons].
abstract: BACKGROUND
  Twins are associated with a delayed development and cerebral palsy. The purpose of this work was to compare the neurologic morbidity in very preterm or very low birth weight dichorionic and monochorionic twins with singletons.
  
  
  METHODS
  We conducted a retrospective cohort study of livebirths lowest through 32 weeks of gestation or very low weight infants admitted to Neonatal Intensive Care Unit of a level III hospital, between 2006 and 2010. Development was evaluated with the Growing Skills II Scale at 24 months of age. Cerebral palsy was defined by predetermined criteria by Surveillance of Cerebral Palsy in Europe. Infants were analyzed as twins and singletons cohort. Within the twin category the infants were further separated as dichorionic and monochorionic and were compared with singletons infants. Logistic regression models were used to control for demographic and clinical factors.
  
  
  RESULTS
  The cohort of infants who were assessed for neurodevelopmental impaired, consisted of 194 singletons infants and 89 twins (50 dichorionic; 39 monochorionic). Monochorionic twins, when compared with the singletons, showed an increased risk of severe developmental delay in these areas: locomotion (adjusted OR 12.2) language (adjusted OR 6.5) and autonomy (adjusted OR 7.2). Cerebral palsy was diagnosed in 4.1% of singleton infants and 15.4% of monochorionic twins. The adjusted risk of severe developmental delay and cerebral palsy in monochorionic twins was 3.6 and 4.2, respectively.
  
  
  CONCLUSIONS
  This work showed higher rate of moderate and severe neurodevelopment delay including cerebral palsy in monochorionic twins compared to singletons infants. Analysis by groups stratified according to gestational age and comparison of monochorionic and dichorionic twins displayed the role of chorionicity for these neurodevelopmental disorders.
  
  
  CONCLUSIONS
  In our sample the monochorionic twins are associated with an independent risk of neurodevelopmental delay.
authors.affiliation: Serviço de Neonatologia. Maternidade Bissaya Barreto. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Adelaide
authors.initials: A
authors.lastname: Taborda
authors.affiliation: Unidade de Neurodesenvolvimento e Autismo. Serviço do Centro de Desenvolvimento da Criança e Centro de Investigação e Formação Clínica. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal; Clínica Universitária de Pediatria e Instituto de Imagem Biomédica e Ciências da Vida. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal.
authors.forename: Guiomar
authors.initials: G
authors.lastname: Oliveira
mesh_terms: D002547:Cerebral Palsy; D002658:Developmental Disabilities; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014429:Twins, Dizygotic; D014430:Twins, Monozygotic
keywords: Córion; Deficiências do Desenvolvimento; Gémeos; Paralisia Cerebral; Recém-Nascido Extremamente Prematuro; Recém-Nascido de Muito Baixo Peso.