Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.
J Obstet Gynaecol. 2023 Dec;43(1):2125300. doi: 10.1080/01443615.2022.2125300. Epub 2022 Sep 29.
This study aimed to evaluate physical and intellectual development of one-year-old infants of monochorionic twins with selective intrauterine growth restriction (sIUGR). A total of 31 pairs of sIUGR twins ageing 1 year old were included in the study. Each pair of sIUGR twins was divided into low birthweight-twin group (L-twin group) and high birthweight-twin group (H-twin group) according to twins' birthweight. The differences in height, weight, head circumstance and body mass index (BMI) in each stage were statistically significant for all measures from birth until 1 year old ( < .05), and there was a disappointed catch-up growth in lighter twins. Psychomotor development index (PDI) and mental development index (MDI) at 1 year old were significantly different between the two groups ( < .05). Stepwise regression analysis showed that the effects of weight on both PDI and MDI were statistically significant ( < .05). Intrauterine growth inconsistencies in monochorionic twins with sIUGR persist until the first year of life and affect low-birthweight infants' physical and intellectual development.Impact Statement Selective intrauterine growth restriction in monochorionic twins increases the risks of intrauterine foetal demise, preterm birth, caesarean delivery and adverse neonatal outcomes, especially in the smaller foetus. Previous studies have concentrated on the clinical management of sIUGR, while little attention has been paid to the growth and development of twins after birth. Given the adverse neurobiological effects of suboptimal nutrition on the brain development, it is important to determine whether IUGR causes long-term cognitive deficits and physical retardation. The current study has assessed the physical and intellectual development of one-year-old infants of monochorionic twins with sIUGR. Intrauterine growth inconsistencies in monochorionic twins with sIUGR persist until the first year of life and affect low-birthweight infants' physical and intellectual development. Further research on the longer-term effects of sIUGR is needed.
本研究旨在评估患有选择性宫内生长受限（sIUGR）的单绒毛膜双胞胎一岁婴儿的体格和智力发育情况。共纳入 31 对 sIUGR 双胞胎，年龄为 1 岁。根据双胞胎的出生体重，将每对 sIUGR 双胞胎分为低出生体重双胞胎组（L-双胞胎组）和高出生体重双胞胎组（H-双胞胎组）。从出生到 1 岁，所有测量值的身高、体重、头围和体重指数（BMI）在各个阶段的差异均有统计学意义（ < .05），较轻的双胞胎存在令人失望的追赶生长。1 岁时的精神运动发育指数（PDI）和精神发育指数（MDI）在两组间差异有统计学意义（ < .05）。逐步回归分析显示，体重对 PDI 和 MDI 的影响均有统计学意义（ < .05）。患有 sIUGR 的单绒毛膜双胞胎的宫内生长不一致持续到生命的第一年，并影响低出生体重婴儿的身体和智力发育。
单绒毛膜双胞胎中的选择性宫内生长受限会增加宫内胎儿死亡、早产、剖宫产和不良新生儿结局的风险，尤其是在较小的胎儿中。以前的研究集中在 sIUGR 的临床管理上，而对出生后双胞胎的生长发育关注较少。鉴于宫内生长受限对大脑发育的不良神经生物学影响，确定宫内生长受限是否导致长期认知缺陷和身体发育迟缓非常重要。本研究评估了患有 sIUGR 的单绒毛膜双胞胎一岁婴儿的体格和智力发育情况。患有 sIUGR 的单绒毛膜双胞胎的宫内生长不一致持续到生命的第一年，并影响低出生体重婴儿的身体和智力发育。需要进一步研究 sIUGR 的长期影响。
