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Fetal Body Composition in Twins and Singletons.

Jessica L Gleason1, Wesley Lee2, Zhen Chen3

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Twin fetuses show reduced fat tissue accumulation compared to singletons, suggesting an early evolutionary adaptive process. This difference in fetal growth is evident from 15 weeks gestation.

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Area of Science:

  • Fetal Development
  • Comparative Anatomy
  • Evolutionary Medicine

Background:

  • Third-trimester fetal growth deceleration in twin pregnancies is increasingly viewed as an evolutionary adaptation.
  • Understanding differential growth trajectories between twins and singletons requires evaluating soft-tissue development.

Purpose of the Study:

  • To compare the longitudinal growth of lean and fat tissue in twin versus singleton fetuses throughout pregnancy.

Main Methods:

  • A prospective cohort study involving dichorionic twins and singletons.
  • Serial ultrasound scans were used to track fetal growth and measure fetal volume for tissue analysis.
  • Data were collected from 12 US clinical centers between 2009-2019, with analysis from 2023-2024.

Main Results:

  • Twin fetuses exhibited significantly smaller abdominal measurements and subcutaneous tissue thickness compared to singletons from 25 to 37 weeks gestation.
  • Fractional thigh volumes (total, fat, and lean) were consistently smaller in twins starting from 15 weeks gestation.
  • Twins demonstrated a proportionally lower fat percentage throughout gestation, with a 2.7% to 4.2% reduction compared to singletons.

Conclusions:

  • Twin fetuses accumulate proportionally less fat tissue in utero compared to singletons, beginning as early as 15 weeks gestation.
  • These findings support the hypothesis of an early evolutionary adaptive process influencing fetal growth in uncomplicated dichorionic twin pregnancies.
  • The consistent observation of smaller sizes and reduced fat accumulation in twins underscores adaptive mechanisms in response to in utero conditions.