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Classification of twins and neonatal morbidity
R Bronsteen1, G Goyert, S Bottoms
1Department of Obstetrics and Gynecology, Hutzel Hospital/Wayne State University, Detroit, Michigan.
Obstetrics and Gynecology
|July 1, 1989
Summary
Evaluating individual twin growth retardation using singleton curves is more effective than discordancy for predicting neonatal morbidity. Focus on individual growth, not discordancy, for better twin health outcomes.
Area of Science:
- Neonatal Medicine
- Perinatology
- Twin Studies
Background:
- Prematurity is the primary cause of neonatal morbidity in twins.
- The prognostic significance of other factors like intrauterine growth retardation (IUGR) and discordancy remains unclear.
Purpose of the Study:
- To compare the predictive value of IUGR, discordancy, and other classifications for neonatal morbidity in twins.
- To develop a model for predicting neonatal morbidity in twin gestations.
Main Methods:
- Analysis of 131 sets of surviving twins.
- Development of a four-factor model for neonatal morbidity using 161 outcome measures.
- Individual assessment of IUGR using singleton growth curves.
Main Results:
- Individual IUGR assessment using singleton curves was superior to discordancy in predicting neonatal morbidity.
- The study identified key factors contributing to neonatal morbidity in twins.
Conclusions:
- Individual twin growth assessment, rather than discordancy, is crucial for predicting neonatal morbidity.
- Singleton growth curves are more effective for evaluating IUGR in twins than twin-specific curves.
- Twins exhibit an increased frequency of growth retardation and associated neonatal morbidity.