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Comparison of fetal growth in singleton, twin, and triplet pregnancies
A Kuno1, M Akiyama, T Yanagihara
1Department of Perinatology, Kagawa Medical University, 1750-1 Ikenobe, Miki, Kagawa 761-0793, Japan.
Insights
Fetal growth patterns differ based on gestational age and number of fetuses. Small for gestational age (S-SGA) fetuses showed the lowest head circumference, while multiple gestations (twin and triplet) had altered abdominal growth curves.
Area of Science:
- Perinatal Medicine
- Fetal Development
- Obstetrics
Background:
- Fetal growth assessment is crucial for identifying potential complications.
- Understanding growth variations in singleton small for gestational age (S-SGA) and multiple gestations (twin and triplet) is essential.
Purpose of the Study:
- To compare fetal and organ growth differences among S-SGA, singleton appropriate for gestational age (S-AGA), twin appropriate for gestational age (Tw-AGA), and triplet appropriate for gestational age (Tri-AGA) fetuses.
Main Methods:
- Longitudinal retrospective study analyzing ultrasonographic data from 35 S-AGA, 18 S-SGA, 52 Tw-AGA, and 12 Tri-AGA fetuses.
- Measurements included head circumference (HC), abdomen circumference (AC), spleen circumference (SC), adrenal gland circumference (AGC), femur diaphysis length (FDL), liver length (LL), and estimated weight (EWT).
- Data collected every two weeks from 15 weeks of menstrual age until delivery.
Main Results:
- S-SGA fetuses exhibited the lowest predicted HC values.
- Abdominal circumference (AC) growth curves showed a lower slope with increasing fetuses per uterus, with no significant difference between Tri-AGA and S-SGA.
- Femur diaphysis length (FDL) was significantly lower in Tw-AGA, Tri-AGA, and S-SGA compared to S-AGA fetuses.
- Spleen (SC) and adrenal gland (AGC) growth curves had lower slopes in S-SGA fetuses with advancing age.
- Estimated weight (EWT) was intermediate in Tw-AGA and Tri-AGA fetuses compared to S-AGA and S-SGA.
Conclusions:
- Fetal growth patterns, particularly head circumference, are lowest in S-SGA fetuses.
- Multiple gestations (twins and triplets) demonstrate distinct abdominal growth trajectories compared to singletons.
- Organ growth, specifically spleen and adrenal glands, shows altered patterns in S-SGA fetuses.
Abstract:
The objective of this longitudinal retrospective study was to evaluate differences of the fetal growth and fetal organ growth among singleton small for gestational age (S-SGA), singleton appropriate for gestational age (S-AGA), twin (Tw-AGA), and triplet (Tri-AGA) infants. Ultrasonographic examinations were performed on 35 S-AGA, 18 S-SGA, 52 Tw-AGA and 12 Tri-AGA fetuses. Circumferences of head (HC), abdomen (AC), spleen (SC) and adrenal gland (AGC) and lengths of femur diaphysis (FDL), liver (LL), estimated weight (EWT) were measured every 2 weeks after 15 weeks of menstrual age until delivery. There was no significant difference in predicted HC values in S-AGA, Tw-AGA and Tri-AGA fetuses; these values were lowest in S-SGA fetuses. As the number of fetuses in the uterus increased with advancing menstrual age, the slope of the growth curve for predicted AC value became lower, but there was no significant difference between Tri-AGA and S-SGA fetuses. There was no significant difference in predicted FDL values among Tw-AGA, Tri-AGA and S-SGA fetuses; those values were significantly lower than that in S-AGA fetuses. There was no significant difference in predicted EWT value between Tw-AGA and Tri-AGA fetuses, which were intermediate between those for S-AGA and S-SGA fetuses. There were no significant differences in predicted SC and AGC values between S-AGA and Tw-AGA fetuses, respectively. However, in S-SGA fetuses, the slopes of the growth curve for SC and AGC were lower than those in the other two groups with advancing menstrual age. There were slight differences in predicted LL values between S-AGA, S-SGA and Tw-AGA fetuses. These results suggest that in AGA fetuses, there was a slight difference in growth pattern among singleton, twin, and triplet pregnancies.