Abstract

To estimate the influence of FGR on neonatal morbidity and mortality among discordant premature twin pairs. Medical records of preterm twins born at 24-37 weeks between 2000 and 2006, were reviewed. Discordancy was defined as a difference of >15% in birth weight. Small for gestational age (SGA) was defined as birth weight <10th percentile, whereas appropriate for gestational age (AGA) was defined as birth weight between the 10th and 90th percentile, according to a twin-adjusted normogram. One group (n=30) included discordant twins which are SGA/AGA pairs and the other group (n=40) included AGA/AGA discordant twin pairs. Neonatal parameters of morbidity and mortality were compared between the pairs of twins. Table 1 depicts the neonatal complications in the AGA/SGA group. The incidence of hyperbilirubinemia, anemia and hypotension were significantly higher among SGA neonates. The incidence of respiratory distress syndrome, apnea and the need for respiratory support was significantly higher among the AGA neonates in the SGA/AGA group. There was no statistically significant difference between the pairs in the incidence of IVH, NEC, sepsis, hyponatremia, hypoglycemia, PDA, neonatal mortality, and length of hospitalization. In the AGA/AGA discordant group there was no difference in any of the neonatal complications between the pairs.Tabled 1AGASGAP valueRDS36.67%16.67%0.014TTN30%3.3%0.004Resp mechan support46.7%16.6%0.003Hyperbilirubin40%70%0.002Phototherapy36.6%66.6%0.003Erythropoietin0%23.3%0.015 Open table in a new tab FGR which leads to SGA among premature twin neonates is associated with significantly lower rates of respiratory morbidity and higher incidence of anemia compared to their AGA sibling. If the discordancy does not lead to SGA, there are no differences between siblings.

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