Teen twin pregnancies: differences in fetal growth outcomes among blacks and whites

We set out to determine the magnitude of black-white disparity in intrauterine fetal growth inhibition among twin births to teenagers (age 15 to 19) in the United States using a retrospective cohort study design. We compared the risk for low and very low birthweight, preterm and very preterm, and small for gestational age between black and white twins born to teen mothers during the period 1995 through 1998. The methodology of generalized estimating equations was used to adjust for the presence of intracluster correlation within twin pairs. A total of 29,307 individual twins were analyzed. For all fetal growth indices examined, infants born to black mothers remained disadvantaged except for preterm birth, for which the risk was comparable to that of whites (adjusted OR, 1.03; 95% confidence interval [CI] 0.95 to 1.11). The racial gap was most marked for low birthweight (OR, 1.27; 95% CI, 1.19, 1.37]) and very low birthweight (OR, 1.30; 95% CI, 1.19 to 1.42). Black twins had an equal level of elevated risk for very preterm and small for gestational age (OR, 1.17; 95% CI, 1.07 to 1.27 and OR, 1.17; 95% CI, 1.07 to 1.28, respectively). In conclusion, we found significant differences in fetal growth parameters between black and white twins born to teen gravidas. Our findings confirm similar black disadvantage reported for singletons. Current prevention strategies aimed at reducing adverse fetal outcomes among teenagers in the United States need to consider the heightened risk among neonates born to black mothers.