3Ds: decorin, discordance, and diamniotic dichorionic twins

Area of Science:

• Reproductive Biology
• Obstetrics and Gynecology
• Perinatal Medicine

Background:

• Dichorionic diamniotic (DD) twin pregnancies present unique challenges, with the causes of discordance remaining unclear.
• Understanding placental differences between discordant and concordant twins is crucial for improving perinatal outcomes.

Purpose of the Study:

• To investigate the role of decorin (DCN) and oxidative/antioxidative status in placental tissue of discordant versus concordant DD twins.
• To identify potential biomarkers for predicting or understanding twin growth discordance.

Main Methods:

• A prospective study involving 43 spontaneous DD twin pregnancies.
• Placental samples were collected and analyzed for decorin (DCN) levels using ELISA and for total oxidant/antioxidant status (TAS/TOS) using automated colorimetric methods.
• Comparison of DCN and oxidative/antioxidative markers between discordant and concordant twin placentas, and between twins of similar birth weight.

Main Results:

• Decorin (DCN) levels were significantly lower in placentas of low birth-weight twins compared to appropriate gestational age twins (p = 0.006).
• When comparing twins of similar birth weight, discordant twins exhibited significantly lower DCN, TAS, and TOS levels (p < 0.001, p < 0.001, and p = 0.002, respectively).
• No significant differences in TAS, TOS, or arylesterase (ARES) were found between discordant and concordant twins overall.

Conclusions:

• Decreased decorin (DCN) levels in discordant twins compared to same birth weight-concordant twins indicate its contribution to the pathogenesis of twin growth discordance.
• Decorin may serve as a potential biomarker in understanding the mechanisms underlying twin pregnancy complications.