Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicza Square 1/3, 02-015 Warsaw, Poland.
Department of Obstetrics and Gynecology, Institute of Mother and Child, Kasprzaka 17a, 01-211 Warsaw, Poland.
Int J Environ Res Public Health. 2021 Feb 19;18(4):2016. doi: 10.3390/ijerph18042016.
Fetal growth of twins differs from singletons. The objective was to assess the fetal growth in twin gestations in relation to singleton charts and customized twin charts, respectively, followed by a comparison of the frequency of neonatal complications in small-for-gestational-age (SGA) twins.
We performed an analysis of twin pregnancies with established chorionicity with particular emphasis on postnatal adverse outcomes in newborns classified as SGA. Neonatal birth weight was comparatively assessed using both singleton and twin growth charts with following percentile estimation. Using a statistical model, we established the prediction strength of neonatal complications in SGA twins for both methods.
The dataset included 322 twin pairs (247 cases of dichorionic and 75 cases of monochorionic diamniotic gestations). Utilization of twin-specific normograms was less likely to label twins as SGA-nevertheless, this diagnosis strongly correlated with risk of observing adverse outcomes. Using a chart dedicated for twin pregnancies predicted newborn complications in the SGA group with higher sensitivity and had better positive predictive value regarding postnatal morbidity.
Estimating twin growth with customized charts provides better prognosis of undesirable neonatal events in the SGA group comparing to singleton nomograms and consequently might determine neonatal intensive care prenatal approach.
双胞胎的胎儿生长与单胎不同。目的是评估双胞胎妊娠中胎儿的生长情况与单胎图表和定制的双胞胎图表的关系，然后比较小胎龄儿（SGA）双胞胎的新生儿并发症发生率。
我们对已确定绒毛膜性的双胎妊娠进行了分析，特别关注分类为 SGA 的新生儿的产后不良结局。使用单胎和双胎生长图表比较评估新生儿的出生体重，并进行随后的百分位数估计。使用统计模型，我们为两种方法建立了 SGA 双胞胎新生儿并发症预测的预测强度。
数据集包括 322 对双胞胎（247 例双绒毛膜性和 75 例单绒毛膜性双羊膜囊妊娠）。使用特定于双胞胎的标准图表不太可能将双胞胎标记为 SGA-尽管如此，这种诊断与观察不良结局的风险强烈相关。使用专门用于双胎妊娠的图表预测 SGA 组的新生儿并发症具有更高的敏感性，并且对产后发病率具有更好的阳性预测值。
与单胎标准图表相比，使用定制图表估计双胞胎的生长情况可以更好地预测 SGA 组中不良新生儿事件的预后，从而可能决定新生儿重症监护产前方法。
