Cortez Ferreira Mariana, Mariano Inês Marques, Marinhas Andreia, Silva Isabel Santos, Taborda Adelaide
Neonatology Department, Maternidade Bissaya Barreto, Unidade Local de Saúde de Coimbra, Coimbra, Portugal.
Obstetrics Department, Maternidade Bissaya Barreto, Unidade Local de Saúde de Coimbra, Coimbra, Portugal.
Eur J Pediatr. 2025 May 1;184(5):319. doi: 10.1007/s00431-025-06155-z.
Weight discordance is a known risk factor for poor perinatal and neonatal outcomes. However, its impact on growth patterns during childhood remains unclear. This study aimed to examine how weight discordance influences the growth of weight, length, and head circumference during the first 36 months of corrected age (CA), according to chorionicity. A retrospective cohort study of monochorionic and dichorionic twin pairs with weight discordance, born between January 1, 2012, and December 31, 2021, in a tertiary maternity hospital. Weight discordance was considered if there was a difference of more than 20% in estimated fetal weight or birth weight between the twins. z-scores for weight, length, and head circumference at birth and at 1, 6, 12, 18, 24, and 36 months of CA were retrieved, and a longitudinal comparison was performed between monochorionic and dichorionic twin pairs. Two hundred thirty-two infants were included: 64 monochorionic and 168 dichorionic. In monochorionic twins, the differences in weight, length, and head circumference between the smaller and larger co-twins closed six months earlier than in dichorionic twins. Head circumference z-scores became similar six months earlier than length z-scores, and length z-scores became similar six months earlier than weight z-scores. Overall, both small and large monochorionic and dichorionic twins showed increases in all growth parameters during the first 36 months CA, with a more notable increase in smaller monochorionic twins.
Inter-twin weight discordance was observed throughout the growth patterns of both larger and smaller twins. Smaller discordant twins showed adequate catch-up growth, leading to no differences in growth parameters compared to their larger co-twins by 36 months. This study highlights the role of chorionicity in the timing of resolution of growth disparities, with differences among dichorionic twins persisting longer.
• Weight discordance is a known risk factor for poor perinatal and neonatal outcomes, but its effect on childhood growth patterns remains unclear. • Previous studies showed persistent weight and length discrepancies during early childhood, but there is limited data on head circumference and time of growth discrepancy resolution.
• Head circumference z-scores in smaller twins caught up more quickly than length and weight z-scores, suggesting different rates of catch-up growth in different growth parameters. • Growth differences between dichorionic discordant twins persist longer than in monochorionic twins, but by 36 months, no differences remained in any growth parameter.
体重不一致是围产期和新生儿不良结局的已知风险因素。然而，其对儿童期生长模式的影响仍不清楚。本研究旨在根据绒毛膜性，探讨体重不一致如何影响矫正年龄（CA）前36个月内体重、身长和头围的生长情况。对2012年1月1日至2021年12月31日在一家三级妇产医院出生的体重不一致的单绒毛膜和双绒毛膜双胎进行回顾性队列研究。如果双胞胎之间估计胎儿体重或出生体重相差超过20%，则认为存在体重不一致。检索出生时以及CA 1、6、12、18、24和36个月时体重、身长和头围的z评分，并对单绒毛膜和双绒毛膜双胎进行纵向比较。纳入232例婴儿：64例单绒毛膜双胎和168例双绒毛膜双胎。在单绒毛膜双胎中，较小和较大的同卵双胎之间体重、身长和头围的差异比双绒毛膜双胎提前6个月闭合。头围z评分比身长z评分提前6个月变得相似，身长z评分比体重z评分提前6个月变得相似。总体而言，在CA的前36个月内，单绒毛膜和双绒毛膜的大小双胎的所有生长参数均有所增加，较小的单绒毛膜双胎增加更为显著。
在大小双胎的整个生长模式中均观察到双胎间体重不一致。较小的不一致双胎显示出足够的追赶生长，到36个月时，其生长参数与较大的同卵双胎相比无差异。本研究强调了绒毛膜性在生长差异解决时间方面的作用，双绒毛膜双胎之间的差异持续时间更长。
• 体重不一致是围产期和新生儿不良结局的已知风险因素，但其对儿童期生长模式的影响仍不清楚。• 先前的研究表明幼儿期体重和身长存在持续差异，但关于头围和生长差异解决时间的数据有限。
• 较小双胎的头围z评分比身长和体重z评分追赶得更快，表明不同生长参数的追赶生长速度不同。• 双绒毛膜不一致双胎之间的生长差异比单绒毛膜双胎持续时间更长，但到36个月时，任何生长参数均无差异。
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