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Growth and development of twins compared with singletons at ages one and four years
S Chaudhari1, M R Bhalerao, U Vaidya
1Department of Pediatrics, K.E.M. Hospital, Pune.
Insights
Twins showed slower growth in height and weight compared to singletons by age four, especially those born small for gestational age (SGA). However, twin intelligence remained within normal limits.
Area of Science:
- Pediatric Growth and Development
- Twin Studies
- Neonatal Outcomes
Background:
- Multiple births, particularly twins, present unique challenges for fetal growth and postnatal development.
- Understanding growth trajectories and developmental milestones in twins is crucial for early identification of potential issues.
Purpose of the Study:
- To compare the growth and developmental outcomes of twins with singleton controls at one and four years of age.
- To assess if twins, especially those born small for gestational age (SGA) or with low birth weight (LBW), exhibit different growth patterns compared to matched singletons.
Main Methods:
- A four-year prospective follow-up study involving twin pairs and singleton controls.
- Measurements included height, weight, and head circumference at one and four years.
- Developmental assessments used the Bayley Scales of Infant Development at one year and the Stanford Binet Intelligence Scale at four years.
Main Results:
- Twins, particularly SGA twins, were lighter and shorter than controls at four years, despite catching up in head circumference.
- Low birth weight (LBW) twins and matched LBW singletons showed similar growth parameters.
- Twin development was within normal limits at one year, with significantly lower motor quotients, and intelligence quotients were normal at four years.
Conclusions:
- Twins, especially SGA twins, experience growth deficits in height and weight by four years compared to singletons.
- LBW twins and LBW singletons exhibit comparable growth trajectories.
- Cognitive development, as measured by intelligence quotient, is not significantly affected in twins by age four.
Objective:
To compare the growth and development of twins with normal control singletons and also with matched 'high risk' singletons, at one and four years of age.
Design:
A four year prospective follow up study.
Setting:
High risk clinic (HRC) of a referral hospital.
Subjects:
Twin pairs enrolled in the HRC; normal full term singleton controls; and high risk "matched" singletons enrolled in the HRC.
Methods:
The height, weight and head circumference was measured at one and four years. Development was assessed at 1 year using the Bayley Scales of Infant Development. At 4 years, the intelligence quotient was determined by the Stanford Binet Intelligence Scale.
Results:
Forty two twins and an equal number of controls were assessed at one year. All the twins weighed less than 2 kg at birth. They lagged behind in all three parameters of growth, namely, height, weight and head circumference. AT 4 years, 24 twins came for follow up. Although, they had caught up for head circumference, they lagged behind in height and weight, particularly the group of fourteen SGA twins. The growth parameters of LBW twins and LBW matched singletons did not show any significant difference. At one year, the development of twins was within normal limits although the motor quotients were significantly lower than that of controls. At 4 years, the intelligence quotients of twins were well within normal limits.
Conclusions:
Twins were lighter and shorter than controls at four years, particularly the SGA twins. The growth parameters of LBW twins and LBW matched singletons showed no significant difference. The intelligence of twins was normal at four years.