A comparison of neonatal outcomes of age-matched, growth-restricted twins and growth-restricted singletons.

A retrospective cohort study was performed to determine whether growth-restricted fetuses of a twin gestation are at increased risk of adverse neonatal outcome compared with growth-restricted singletons. One cohort was comprised of 48 growth-discordant twin pregnancies in which the birth weight of the smaller twin was less than the tenth percentile. The neonatal outcomes of the 48 growth-restricted twin infants were compared with a cohort of 96 singleton infants matched by gestational age, degree of growth restriction, and gender. Outcomes evaluated included: length of stay, days of assisted ventilation, and diagnoses of morbidities of prematurity, congenital abnormalities, and neonatal death. No significant difference was detected in rates of neonatal morbidity or mortality. The overall neonatal death rate in the twins was 125 of 1000 and in the singletons was 104 of 1000 (Odds ratio 1.2, 95% confidence interval [CI]0.4-3.3). Growth-restricted twins have similar rates of adverse neonatal outcomes as compared with growth-restricted singletons. Both have high rates of morbidity and neonatal death. Twins and singletons should receive comparable diagnostic evaluation and antepartum management for growth restriction.