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Kidney growth in twin children born small for gestational age

Vasileios Giapros1, Aikaterini Drougia, Efthalia Hotoura

  • 1Neonatal Intensive Care Unit, University Hospital of Ioannina, Leoforos Stavrou Niarhou, Ioannina, Greece. vgiapros@cc.uoi.gr

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|May 18, 2010
PubMed

Insights

Twin infants born small for gestational age (SGA) with very low birth weight (<3rd percentile) show persistently reduced kidney length. Premature SGA twins with higher birth weight show catch-up kidney growth, but long-term monitoring is advised.

Area of Science:

  • Pediatric Nephrology
  • Neonatal Development
  • Fetal Medicine

Background:

  • Low birth weight (LBW) is linked to adult diseases like hypertension and renal disease.
  • Intrauterine growth restriction (IUGR) may alter renal development, impacting long-term health.
  • Longitudinal data on renal growth in small for gestational age (SGA) twin infants is lacking.

Purpose of the Study:

  • To prospectively assess longitudinal renal size in twin infants born small for gestational age (SGA) during their first two years of life.
  • To investigate the impact of gestational age and birth weight percentile on renal growth in SGA twins.

Main Methods:

  • Included 613 children: 145 SGA twins, 141 appropriate for gestational age (AGA) twins, 148 AGA singletons, and 179 SGA singletons.
  • Classified infants by gestational age (<36 and >36 weeks) and IUGR severity (birth weight <3rd percentile or 3rd-10th percentile).
  • Utilized serial renal ultrasonography to measure kidney length (KL) at corrected ages of 36, 40 weeks, and 3, 6, 12, 24 months.

Main Results:

  • All SGA twin subgroups exhibited lower kidney length (KL) at 40 weeks corrected age.
  • SGA twins born after 36 weeks showed catch-up KL, reaching levels similar to AGA twins and singletons.
  • Premature SGA twins (<36 weeks) with birth weight in the 3rd-10th percentile achieved catch-up KL, unlike those with birth weight <3rd percentile.
  • No significant KL differences were observed between twin and singleton SGA or AGA groups.
  • Intrapair birth weight differences correlated with intrapair KL differences.

Conclusions:

  • Twin infants born prematurely small for gestational age with birth weight below the 3rd percentile do not achieve catch-up kidney length within the first 24 months.
  • Long-term follow-up is recommended for these high-risk infants to monitor renal development and potential health outcomes.
Abstract

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