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Twins, asymmetric growth restriction, and perinatal morbidity
1Department of Obstetrics and Gynecology, University of South Florida, Tampa 33606, USA.
Objective:
Our objective in this study was to evaluate decreased weight/length ratio as a correlate of perinatal morbidity in twins.
Study Design:
Rates of weight/length ratio less than 10% (low WL) were compared in 986 neonates from twin gestations and 4929 matched singletons. Low WL was compared with birth weight less than 10% (SGA) and 25% birth weight discordance as a marker for perinatal depression and neonatal mortality.
Results:
Both SGA (42% vs 8%) and low WL (38% vs 8%) occurred more commonly in twins. Low WL was a better correlate of depression and mortality than SGA or 25% birth weight discordance. After adjustment for major anomalies, prematurity, and low WL, perinatal morbidity in twins and singletons did not differ.
Conclusions:
Low WL, a marker of asymmetric growth restriction, is a better marker for perinatal morbidity in twins than SGA or 25% discordance. Twins and singletons have similar rates of perinatal morbidity and mortality after adjustment for anomalies, prematurity, and growth restriction.